New to our Vendor ACH Program? Call Us or Fill The Form: ATTC Manufacturing, Inc. is an equal opportunity employer. Address Details 10455 IN-37, Tell City, IN 47586 Email attc@attcmfg.com Phone Number 812-547-5060 ENTITY INFORMATION Company Name (as listed on line 1 of W9)* Doing Business As Name (if different from legal entity name) Phone Number* Phone Number Extension Fax Company Physical Address: Street* City* State* —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther Zip Code* Country* —Please choose an option—United StatesJapanCanadaAfghanistanAland Islands (Finland)AlbaniaAlgeriaAmerican Samoa (USA)AndorraAngolaAnguilla (UK)Antigua and BarbudaArgentinaArmeniaAruba (Netherlands)AustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermuda (UK)BhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBritish Virgin Islands (UK)BruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCape VerdeCaribbean Netherlands (Netherlands)Cayman Islands (UK)Central African RepublicChadChileChinaChristmas Island (Australia)Cocos (Keeling) Islands (Australia)ColombiaComorosCook Islands (NZ)Costa RicaCroatiaCubaCuracao (Netherlands)CyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (UK)Faroe Islands (Denmark)Federated States of MicronesiaFijiFinlandFranceFrench Guiana (France)French Polynesia (France)GabonGambiaGeorgiaGermanyGhanaGibraltar (UK)GreeceGreenland (Denmark)GrenadaGuadeloupe (France)Guam (USA)GuatemalaGuernsey (UK)GuineaGuinea-BissauGuyanaHaitiHondurasHong Kong (China)HungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of Man (UK)IsraelItalyIvory CoastJamaicaJersey (UK)JordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau (China)MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (France)MauritaniaMauritiusMayotte (France)MexicoMoldovMonacoMongoliaMontenegroMontserrat (UK)MoroccoMozambiqueNamibiaNauruNepalNetherlandsNew Caledonia (France)New ZealandNicaraguaNigerNigeriaNiue (NZ)Norfolk Island (Australia)North KoreaNorthern Mariana Islands (USA)NorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn Islands (UK)PolandPortugalPuerto RicoQatarRepublic of the CongoReunion (France)RomaniaRussiaRwandaSaint Barthelemy (France)Saint Helena, Ascension and Tristan da Cunha (UK)Saint Kitts and NevisSaint LuciaSaint Martin (France)Saint Pierre and Miquelon (France)Saint Vincent and the GrenadinesSamoaSan MarinoSao Tom and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen (Norway)SwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelau (NZ)TongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos Islands (UK)TuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Virgin Islands (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and Futuna (France)Western SaharaYemenZambiaZimbabwe Payment Remit Mailing Address: Street* City* State* —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther Zip Code* Country* —Please choose an option—United StatesJapanCanadaAfghanistanAland Islands (Finland)AlbaniaAlgeriaAmerican Samoa (USA)AndorraAngolaAnguilla (UK)Antigua and BarbudaArgentinaArmeniaAruba (Netherlands)AustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermuda (UK)BhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBritish Virgin Islands (UK)BruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCape VerdeCaribbean Netherlands (Netherlands)Cayman Islands (UK)Central African RepublicChadChileChinaChristmas Island (Australia)Cocos (Keeling) Islands (Australia)ColombiaComorosCook Islands (NZ)Costa RicaCroatiaCubaCuracao (Netherlands)CyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (UK)Faroe Islands (Denmark)Federated States of MicronesiaFijiFinlandFranceFrench Guiana (France)French Polynesia (France)GabonGambiaGeorgiaGermanyGhanaGibraltar (UK)GreeceGreenland (Denmark)GrenadaGuadeloupe (France)Guam (USA)GuatemalaGuernsey (UK)GuineaGuinea-BissauGuyanaHaitiHondurasHong Kong (China)HungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of Man (UK)IsraelItalyIvory CoastJamaicaJersey (UK)JordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau (China)MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (France)MauritaniaMauritiusMayotte (France)MexicoMoldovMonacoMongoliaMontenegroMontserrat (UK)MoroccoMozambiqueNamibiaNauruNepalNetherlandsNew Caledonia (France)New ZealandNicaraguaNigerNigeriaNiue (NZ)Norfolk Island (Australia)North KoreaNorthern Mariana Islands (USA)NorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn Islands (UK)PolandPortugalPuerto RicoQatarRepublic of the CongoReunion (France)RomaniaRussiaRwandaSaint Barthelemy (France)Saint Helena, Ascension and Tristan da Cunha (UK)Saint Kitts and NevisSaint LuciaSaint Martin (France)Saint Pierre and Miquelon (France)Saint Vincent and the GrenadinesSamoaSan MarinoSao Tom and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen (Norway)SwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelau (NZ)TongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos Islands (UK)TuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Virgin Islands (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and Futuna (France)Western SaharaYemenZambiaZimbabwe Sales Contact: Name* Title* Email Address* Phone Number* Phone Number Extension Email Address for Submitting Purchase Orders* Accounts Receivable Contact: Name* Title* Email Address* Phone Number* Phone Number Extension Payment Terms & Required Information: Select a payment term* —Please choose an option—.5% 10, Net 25.5% 10, Net 30.5% 15, Net 25.5% 15, Net 301% 10, Net 251% 10, Net 301% 15, Net 301% 20, Net 301% 25, Net 301% 7, Net 1510th of the month2% 10, Net 302% 15, Net 302% 20, Net 302nd week of month3% 15, Net 303rd week of monthMonth + 30Net 0Net 10Net 15Net 20Net 25Net 30Net 45Net 60Net 90 Minority Status* —Please choose an option—NoYes If Minority Status is yes, please upload MBE Certificate using the button below Tax ID (EIN or SSN)* Federal Tax Classification* —Please choose an option—Individual/Sole Proprietor or Single-Member LLCC CorporationS CorporationPartnershipTrust/EstateLimited Liability Company - C CorporationLimited Liability Company - S CorporationLimited Liability Company - PartnershipOTHER (Please describe on W-9) Please upload your W-9 Form using the button below* Any Additional Certifications?* —Please choose an option—NoYes If yes, please Upload Additional Certifications using the button below (example: TS16949, ISO 9001, etc.) D & B Number VENDOR ACH DETAILS/WIRE INFO Bank Name* Bank Street Address* Bank City* Bank State* —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYOther Bank Zip Code* Bank Country* —Please choose an option—United StatesJapanCanadaAfghanistanAland Islands (Finland)AlbaniaAlgeriaAmerican Samoa (USA)AndorraAngolaAnguilla (UK)Antigua and BarbudaArgentinaArmeniaAruba (Netherlands)AustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermuda (UK)BhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBritish Virgin Islands (UK)BruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCape VerdeCaribbean Netherlands (Netherlands)Cayman Islands (UK)Central African RepublicChadChileChinaChristmas Island (Australia)Cocos (Keeling) Islands (Australia)ColombiaComorosCook Islands (NZ)Costa RicaCroatiaCubaCuracao (Netherlands)CyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (UK)Faroe Islands (Denmark)Federated States of MicronesiaFijiFinlandFranceFrench Guiana (France)French Polynesia (France)GabonGambiaGeorgiaGermanyGhanaGibraltar (UK)GreeceGreenland (Denmark)GrenadaGuadeloupe (France)Guam (USA)GuatemalaGuernsey (UK)GuineaGuinea-BissauGuyanaHaitiHondurasHong Kong (China)HungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of Man (UK)IsraelItalyIvory CoastJamaicaJersey (UK)JordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau (China)MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (France)MauritaniaMauritiusMayotte (France)MexicoMoldovMonacoMongoliaMontenegroMontserrat (UK)MoroccoMozambiqueNamibiaNauruNepalNetherlandsNew Caledonia (France)New ZealandNicaraguaNigerNigeriaNiue (NZ)Norfolk Island (Australia)North KoreaNorthern Mariana Islands (USA)NorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn Islands (UK)PolandPortugalPuerto RicoQatarRepublic of the CongoReunion (France)RomaniaRussiaRwandaSaint Barthelemy (France)Saint Helena, Ascension and Tristan da Cunha (UK)Saint Kitts and NevisSaint LuciaSaint Martin (France)Saint Pierre and Miquelon (France)Saint Vincent and the GrenadinesSamoaSan MarinoSao Tom and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen (Norway)SwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelau (NZ)TongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos Islands (UK)TuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Virgin Islands (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and Futuna (France)Western SaharaYemenZambiaZimbabwe ABA (Routing #)* Can you confirm that the ABA (Routing #) above is correct? Bank Account #* Can you confirm that the Bank Account # above is correct? Swift # (If Applicable) Can you confirm that the Swift # (If Applicable) above is correct? Account Type* —Please choose an option—DA-Demand/Checking AccountSG-Savings Account Currency* —Please choose an option—USD - United Stated DollarJPY - Japanese YenAbkhazian apsarAfghan afghaniAlbanian lekAlderney poundAlgerian dinarAngolan kwanzaArgentine pesoArmenian dramAruban florinAscension poundAustralian dollarAzerbaijani manatBahamian dollarBahraini dinarBangladeshi takaBarbadian dollarBelarusian rubleBelize dollarBermudian dollarBhutanese ngultrumBolivian bolivianoBosnia and Herzegovina convertible markBotswana pulaBrazilian realBritish poundBritish Virgin Islands dollarBrunei dollarBulgarian levBurmese kyatBurundian francCambodian rielCanadian dollarCape Verdean escudoCayman Islands dollarCentral African CFA francCFP francChilean pesoChinese yuanColombian pesoComorian francCongolese francCook Islands dollarCosta Rican colónCroatian kunaCuban convertible pesoCuban pesoCzech korunaDanish kroneDjiboutian francDominican pesoEast Caribbean dollarEgyptian poundEritrean nakfaEthiopian birrEuroFalkland Islands poundFaroese krónaFijian dollarGambian dalasiGeorgian lariGhana cediGibraltar poundGuatemalan quetzalGuernsey poundGuinean francGuyanese dollarHaitian gourdeHonduran lempiraHong Kong dollarHungarian forintIcelandic krónaIndian rupeeIndonesian rupiahIranian rialIraqi dinarIsraeli new shekelJamaican dollarJersey poundJordanian dinarKazakhstani tengeKenyan shillingKiribati dollarKuwaiti dinarKyrgyzstani somLao kipLebanese poundLesotho lotiLiberian dollarLibyan dinarMacanese patacaMacedonian denarMalagasy ariaryMalawian kwachaMalaysian ringgitMaldivian rufiyaaManx poundMauritanian ouguiyaMauritian rupeeMexican pesoMicronesian dollarMoldovan leuMongolian tögrögMoroccan dirhamMozambican meticalNagorno-Karabakh dramNamibian dollarNauruan dollarNepalese rupeeNetherlands Antillean guilderNew Taiwan dollarNew Zealand dollarNicaraguan córdobaNigerian nairaNiue dollarNorth Korean wonNorwegian kroneOmani rialPakistani rupeePalauan dollarPanamanian balboaPapua New Guinean kinaParaguayan guaraníPeruvian nuevo solPhilippine pesoPitcairn Islands dollarPolish złotyQatari riyalRomanian leuRussian rubleRwandan francSahrawi pesetaSaint Helena poundSamoan tālāSão Tomé and Príncipe dobraSaudi riyalSerbian dinarSeychellois rupeeSierra Leonean leoneSingapore dollarSolomon Islands dollarSomali shillingSomaliland shillingSouth African randSouth Georgia and the South Sandwich Islands poundSouth Korean wonSouth Sudanese poundSri Lankan rupeeSudanese poundSurinamese dollarSwazi lilangeniSwedish kronaSwiss francSyrian poundTajikistani somoniTanzanian shillingThai bahtTongan paʻangaTransnistrian rubleTrinidad and Tobago dollarTristan da Cunha poundTunisian dinarTurkish liraTurkmenistan manatTuvaluan dollarUgandan shillingUkrainian hryvniaUnited Arab Emirates dirhamUruguayan pesoUzbekistani somVanuatu vatuVenezuelan bolívarVietnamese đồngWest African CFA francYemeni rialZambian kwachaZimbabwean Bond Email Address for Submitting Remittance Advice* E-SIGNATURE & CONFIRMATION Form Completed By:* Title:* Date: (Format: MM-DD-YYYY)* Δ