GLOBAL VENDOR INFORMATION REQUEST FORM

If adding a new vendor, please complete pages 1-3. Otherwise fill out information to be changed.

Add New Vendor Add New AP Site Add New PO Site

Update Vendor Information Update AP Site/Name Change Update PO Site Details

Tag to Americas (see page 4) Tag to ATC (see page 5) Tag to EMEA

Deactivate Vendor Site Tag _____ for Update System to Tag

Company Name:

Former Name:

Vendor Number: Vendor Site #: D&B #:

Payment Terms: (Needs signature approval from Sector Controller if other than net 45)

Sector Controller Signature (if other than net 45):

Schedule Sharing Vendor: √ Yes No RFQ Only Vendor #: Yes √ No

*Vendor Contact Name (for TIGERS):

*Vendor Contact Phone #(for TIGERS):

*Vendor E-mail Address (for TIGERS):

Organization Type:

Corporation Partnership Individual/Sole Proprietorship

Government Agency Utility Other _________________

*Order Method(for TIGERS): EDI TPE E-mail Other:

Payment Method: Check EFT (Fill out page 6) Wire Transfer (Fill out page 7)

Supplier Invoice Method: Pay On Invoice(POI) Pay from Receipt(PFR)

*Regions Identifier (for TIGERS): Americas EMEA Asia

* Required if record is tagged to TIGERS

New Site (if applicable): Former Site (if applicable): N/A

New Remit to Address: Old Remit to Address:

City/State:

Province: Country / Postal Code:

AR Contact Name: AR Contact Phone #:

AR Contact e-mail address: AR Fax #:

Paydate Basis (Due or Discount) Take Discount (Yes /No)

Invoice Currency: Payment Currency:

Same as AP Site: Yes. Omit this section No. Please complete this section

Former PO Site (if applicable):

New Remit to Address: Old Remit to Address:

City/State:

Province: Country / Postal Code:

Contact Name: Contact Phone #: ( )

Contact e-mail address: PO Fax #: ( )

Paydate Basis (Due or Discount) Take Discount (Yes /No)

Invoice Currency: Payment Currency:

Alternate Pay Site (if applicable):

(Check all that apply)

Requested by: Signature:

Phone: Date:

Core ID/E-mail: Business Group:

Purchasing and/or TIGERS Approval Signature:

Requestor information is required for notification of GVM setup.

Please fax this completed form and required attachments to appropriate service center:

US-FSS: +1-847-538-2455 EMEA-FSS (UK): +44-131-479-7190

EMEA-FSS (Germany): +44-131-479-7190 ASIA-FSS(CHN,SGP,HK,TW,ANZ,ASEAN): +86-22-25208155

ASIA-FSS (JPN): +86-22-6620-1547 (KR): +82-2-3466-5059 (IND): +91-80-5596470

GLOBAL VENDOR INFORMATION REQUEST FORM – ADDITIONAL AMERICAS INFORMATION

This information is to be filled out if vendor is tagged to Americas

Federal Tax ID Number: ___ ___ - ___ ___ ___ ___ ___ ___ ___

Federal Tax ID Number is required unless company tax returns are filed under an owner’s social security number.

Social Security Number: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

NOTE:

GLOBAL VENDOR INFORMATION REQUEST FORM – ADDITIONAL ATC INFORMATION

This information is to be filled out if vendor is tagged to ATC

Company Name (Local Language):

Tax ID Number:

Company Sales: Year: Number of Years in Business:

Major (active) Customers:

Motorola Facilities Currently Doing Business With:

Major Products/Services:

Company Owner (Denial Person’s List verification)?:

Bank charge bearer:

Please attach copies of document (where applicable to country)

a. Business Registration Certificate/Business License

b. Memorandum of Articles and Association/Directors Name

c. Bank statements / Bank Letter

d. Tax Registration

e. Copy of Invoice or Company Letterhead with address

Declaration:

I/We hereby declare the information provided above to be true and correct and no employee of Motorola has any vested interest in my/our company . Permission is hereby granted to Motorola to inquire upon any person, company or authority regarding my/our business status.

__

Name/Title (vendor) Authorized signature $ Company stamp

__

Name/ Title (Motorola requestor) Signature

__

Motorola Finance manager Approval signature

__

Commodity/Sourcing Manager Sourcing Director

EFT ENROLLMENT FORM

This information is to be filled out if vendor is selecting EFT

Add a New Bank Account Modify Existing Bank Account Delete Bank Account

Supplier Name Supplier ID:

Bank T/R Number: Bank Name: Branch #

Account Number: Bank Contact:

Bank Address: City: State: Zip:

Account Type: ______Checking ______Savings Bank Phone Number:

______ Option A Electronic payment with remittance detail via EDIBANX or ACH CTX.

NOTE: If your company is a member of EDIBANX by default the payment will

be sent via EDIBANX unless noted otherwise.

______ Option B Electronic (ACH CCD+) payment with direct 820 remittance detail.

VAN Name: ________________________________________

ISA 07: ____________________________________________

ISA 08: ____________________________________________

Version: ____________________________________________

______ Option C Electronic (ACH CCD+) payment with fax remittance detail.

Name: _____________________________________________

Fax Number: ________________________________________

Contact Name: _______________________________________________________

Phone Number: _____________________________________ Fax Number: ___________________________________

Authorized by: _____________________________________ Phone Number: _________________________________

FOR BANK USE ONLY

Entered by: ________________________________________ Date: _______________ Time: _______________

Verified by: ________________________________________ Date: _______________ Time:_______________

WIRE ENROLLMENT/NETTING REQUEST FORM

This information is to be filled out if vendor is selecting Wire Transfer

DATE REQUESTED: SUBMITTED BY:

COMPANY NAME:

COMPANY ADDRESS:

CITY: STATE: ZIP/POSTAL CODE: COUNTRY:

BANK ACCOUNT NUMBER: PAYMENT CURRENCY:

BANK SWIFT CODE (8 or 11 Digit Alpa/Numeric Routing #):

CANADA VENDORS ONLY – Please be advised when Motorola makes a payment via wire transfer it is sent out through our Netting Center in England. In order for a Canadian Bank to supply a Swift Code please let the bank know that your company will be receiving a payment from out of the country.

BANK NAME:

BANK STREET ADDRESS:

CITY: STATE: ZIP/POSTAL CODE: COUNTRY:

* All above fields must be filled out completely to be set up on Wire Transfer – Incomplete forms will be rejected

CORRESPONDENT BANK SWIFT CODE:

CORRESPONDENT BANK NAME:

BANK STREET ADDRESS:

CITY: STATE: ZIP/POSTAL CODE: COUNTRY:

FAX OR EDI (COMPLETE ONE OPTION)*

FAX REMITTANCE ADVICE TO:

FAX NUMBER: Country Code: City Code: Phone Number:

OR

BANK EDI ID NUMBER :

*Must have one of the options for remittance detail filled out – Incomplete forms will be rejected.

AUTHORIZED BY: ___________________________________________________________________________

PHONE NUMBER: Country Code: City Code: Phone:

FAX NUMBER: Country Code: City Code: Phone:

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