+---------------------------------+-----+---------------+---+---+---+------+
| **ELECTRONIC FUNDS WIRE         |     |               |   |   |   |      |
| TRANSFER [FOREIGN VENDOR        |     |               |   |   |   |      |
| BANKING]{.underline}**          |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| The Debt Collection Improvement |     |               |   |   |   |      |
| Act of 1996, effective July 26, |     |               |   |   |   |      |
| 1996, mandates the use of       |     |               |   |   |   |      |
| Electronic Funds Transfer (EFT) |     |               |   |   |   |      |
| for all Federal payments to     |     |               |   |   |   |      |
| recipients who become eligible  |     |               |   |   |   |      |
| to receive such payments 90     |     |               |   |   |   |      |
| days after enactment, which was |     |               |   |   |   |      |
| July 26, 1996. Federal agencies |     |               |   |   |   |      |
| may grant waivers for this      |     |               |   |   |   |      |
| mandate to recipients who       |     |               |   |   |   |      |
| certify in writing and send     |     |               |   |   |   |      |
| documentation to the Finance    |     |               |   |   |   |      |
| Office stating that they [do    |     |               |   |   |   |      |
| not have an account with a      |     |               |   |   |   |      |
| financial                       |     |               |   |   |   |      |
| institution]{.underline}.       |     |               |   |   |   |      |
|                                 |     |               |   |   |   |      |
| The Central Contractor          |     |               |   |   |   |      |
| Registration (CCR)              |     |               |   |   |   |      |
| <ht                             |     |               |   |   |   |      |
| tp://www.ccr.gov/handbook.cfm>, |     |               |   |   |   |      |
| is the primary vendor data base |     |               |   |   |   |      |
| to register and provide the     |     |               |   |   |   |      |
| vendor's financial payment      |     |               |   |   |   |      |
| data. All registrants must      |     |               |   |   |   |      |
| complete the Financial          |     |               |   |   |   |      |
| Information section, [except,   |     |               |   |   |   |      |
| for foreign vendors doing       |     |               |   |   |   |      |
| business outside the            |     |               |   |   |   |      |
| U.S]{.underline}, utility       |     |               |   |   |   |      |
| companies and federal           |     |               |   |   |   |      |
| government agencies.            |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Foreign vendors ONLY please   |     |               |   |   |   |      |
| provide the following financial |     |               |   |   |   |      |
| information for Wire Transfer   |     |               |   |   |   |      |
| Payments (The Wire Transfer     |     |               |   |   |   |      |
| Coordinator at your financial   |     |               |   |   |   |      |
| institution can supply you with |     |               |   |   |   |      |
| this information.)**            |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **ALL INFORMATION MUST BE       |     |               |   |   |   |      |
| COMPLETED\***                   |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **ABA \# of US                  |     |               |   |   |   |      |
| Bank/Intermediary Bank**        |     |               |   |   |   |      |
| (9-digit Routing Number)        |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Name of US Bank /Intermediary |     |               |   |   |   |      |
| Bank** (maximum 18 characters)  |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **City Location of US           |     |               |   |   |   |      |
| Bank/Intermediary Bank**        |     |               |   |   |   |      |
| (maximum 15 characters)         |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **State Location of US          |     |               |   |   |   |      |
| Bank/Intermediary Bank** (2     |     |               |   |   |   |      |
| characters)                     |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Beneficiary Bank (BBK) Name   |     |               |   |   |   |      |
| of Foreign Bank or Bank to      |     |               |   |   |   |      |
| receive the Further Credit/     |     |               |   |   |   |      |
| Transfer** (maximum 47          |     |               |   |   |   |      |
| characters)                     |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Depositor Account Number**    |     |               |   |   |   |      |
| (maximum 17 characters)         |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Beneficiary (BNF) Vendor or   |     |               |   |   |   |      |
| Payee's Name *Must match the    |     |               |   |   |   |      |
| Bank Acct Name*** (maximum 47   |     |               |   |   |   |      |
| characters)                     |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **BBK Remarks - *Swift Code,    | B   |               |   |   |   |      |
| IBAN#, Transit #, other bank    | BI: |               |   |   |   |      |
| code data, Beneficiary Bank's   |     |               |   |   |   |      |
| City & Country.*** (maximum 72  |     |               |   |   |   |      |
| characters)                     |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Additional Payment Remarks *- |     |               |   |   |   |      |
| Beneficiary Bank\'s street/box  |     |               |   |   |   |      |
| \# address, /Further Credit to  |     |               |   |   |   |      |
| or Transfer Bank\'s Name &      |     |               |   |   |   |      |
| address, other payment          |     |               |   |   |   |      |
| instructions, and overflow data |     |               |   |   |   |      |
| from BBK Remarks*** (maximum    |     |               |   |   |   |      |
| 100 characters)                 |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **Vendor\'s Certification - I   |     |               |   |   |   |      |
| certify the information that I  |     |               |   |   |   |      |
| have provided on this form is   |     |               |   |   |   |      |
| correct.**                      |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Name                            |     | Title         |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Phone                           |     | Date          |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Signature                       |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| **(Internal Use) ASC *Finance   |     |               |   |   |   |      |
| Office: I certify that the      |     |               |   |   |   |      |
| financial payment data provided |     |               |   |   |   |      |
| by the Vendor on this form has  |     |               |   |   |   |      |
| been accurately posted to the   |     |               |   |   |   |      |
| CFS PM002 Vendor File. ***      |     |               |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Name                            |     | Title         |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Phone                           |     | Date          |   |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+
| Signature                       |     |               | A |   |   |      |
|                                 |     |               | S |   |   |      |
|                                 |     |               | C |   |   |      |
|                                 |     |               | : |   |   |      |
+---------------------------------+-----+---------------+---+---+---+------+