Privacy Act Statement. The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This information will be used by the Treasury Department to transmit payment data, by electronic means to vendor's financial institution. Failure to provide the requested information may delay or prevent the receipt of payments through the Automated Clearing House Payment System. FEDERAL PROGRAM AGENCY AGENCY IDENTIFIER: AGENCY LOCATION CODE (ALC): ACH FORMAT: CCD+ CTX ADDRESS: CONTACT PERSON NAME: TELEPHONE NUMBER: ( ) ADDITIONAL INFORMATION: NAME SSN NO. OR TAXPAYER ID NO. ADDRESS CONTACT PERSON NAME: TELEPHONE NUMBER: ( ) NAME:
Appears in 4 contracts
Samples: Cooperative and Joint Venture Agreement, Cooperative Agreement, Cooperative Agreement
