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**Federal Express Contract Account Information for Automated Services**

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Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PLEASE INDICATE THE ACTION BELOW:

\_\_\_\_ **ESTABLISH** a new Federal Express account\*

\*Complete entire form and submit to Donald Still, SSMC4, OFA722, Room
8520 or fax to 301-713-2303.

\_\_\_\_ **MODIFY** existing account information\*\*

\*\*Complete only changed information and submit to Vicki Holsey,
OFA231, Station 2127, Germantown or fax it to 301-427-3242.

\_\_\_\_ **DELETE** and existing Federal Express account\*\*\*

\*\*\*Only the Federal Express account number is required. Submit this
form to Vicki Holsey, OFA231, Station 2127, Germantown or fax it to
301-427-3242.

**FEDERAL EXPRESS ACCOUNT NUMBER: (REQUIRED)**

\_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_ - \_\_\_\_ \_\_\_\_ \_\_\_\_
\_\_\_\_ - \_\_\_\_

Department this account reports to: Department of Commerce

Agency this account reports to: National Oceanic and Atmospheric
Administration (NOAA)

Agency Location Code: 13-14-0001

Are you a contractor of a Government Agency? \_\_\_\_ Yes \_\_\_\_ No

**PLEASE GO ON TO THE NEXT PAGE**

**SHIPPER INFORMATION**

**Account Name**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(NOAA Organization, i.e. Office of Finance and Administration, National
Ocean Service, etc.)

**Address Line 1**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Building Code, Room/Suite Number, i.e. SSMC3, Room 12345

**Address Line 2**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Building Number and Street, i.e. 1315 East West Highway)

**City** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **State
and Zip Code** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Contact Person**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Phone**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Internet E-mail Address**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(i.e. [John.Smith@noaa.gov)]{.underline}

**PLEASE GO ON TO THE NEXT PAGE**

**BILLING INFORMATION**

**Account Name**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(If different from Shipper Account Name)

**Address Line 1**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Address Line 2**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**City** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**State & Zip Code** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Billing Contact** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Phone
Number** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**NOAA DEFAULT ACCOUNTING INFORMATION**

**(CAMS accounting information is required, if known, otherwise FIMA)**

**CAMS**:

Organization Code \_\_\_ \_\_\_ - \_\_\_ \_\_\_ - \_\_\_ \_\_\_ \_\_\_
\_\_\_ - \_\_\_ \_\_\_ - \_\_\_ \_\_\_ - \_\_\_ \_\_\_ - \_\_\_ \_\_\_

Project Code \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_

Task Code \_\_\_ \_\_\_ \_\_\_

**FIMA**:

Organization Code \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_

Task Code \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_ \_\_\_

Phase Code \_\_\_ \_\_\_

**END**