Payee Information Form

PAYEE INFORMATION FORM

This form is intended to be used by any new orregistered Intel’s supplier or other kind of entity in order to include or update the profile information into Intel’s Supplier Database for procurement and/or payment activities.

Please send this document back duly completed using the OTP (one time password) system (link and password sent by email). If you have any problem with your OTP, or any doubt or concern about the information to provide, please contact . Please be aware that you might be contacted by in case additional confirmation is required on our end.

Intel is committed to respect your privacy and confidential data. For more information on Intel’s personal information handling practices, please visit

Company or Entity / Government/Tax Authority / Sole Proprietor or Partnership / Individual

This form works better using MS WORD with letter page size (21.59 cm x 27.94 cm or 8.5" x 11")

Section 1: Company name and Tax information

*Legal Company Name: / Note: This field works also to set your name if you are doing business as an individual.
Note: Legal company name is not the same as legal representative name.
Business Trade Name:
Note: UseTrade name, not business nature.
*Tax ID: / Note: The Tax ID varies based on your country or region’s legislation. Example:
USA: FEIN/SSC, Europe: VAT/Tax ID, Philippines: TIN, Malaysia / Singapore: GST
If you intend to update the company names already registered, please provide the details below
Former Legal Name:
Former Business Trade Name:
Reason for Name Change(Please select)
Bought out / Merger / Other reason:
Former Tax ID: / Note: If the TAX ID changed, please provide the previous one.

Section 2: Address information

Note: If the “Remit to” address is different than the “Order From” please include it.

*Address (Order From) / Remit to Address (if different)
Address:
(or P.O. Box)
ZIP/Post. Cod - City:
State or Province:
Country:
DUNS Number: / If available / If available
Note: Duns & Bradstreet DUNS numbers are a standard 9 digit numberused to identify companies worldwide and each physical address has its own uniqueDUNS.
If you don’t have one, please visit request it. It’s recommended in order to access supplier.intel.com
More information at supplier.intel.com/seem/CompanyIDRequestProcess.asp

Section 3: Contact information

Please specify your Sales Representative contact and the appropriate contact to address Billing and Payment questions.

Sales Representative / * / Invoicing and Payments Contact
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Important considerations about email domain(this doesn’t apply for individuals):

1. If the contact email doesn’t carry a domain related to any of the company names depicted in Section 1, please explain the relationship in the field below.
2. If the email domain is a public one (not corporative) like “@hotmail.com”, “@123.com”, etc., please provide a scanned copy of the company business license, or business registration, or certificate of incorporation, or a tax certification, or similar in your country.

Section 4: Bank information

* / Bank Name: / * / Bank Account Currency
* / Address: / USD - United States DollarEUR - EUROAED - United Arab Emirates DirhamAUD - Australia DollarCAD - Canada DollarGBP - United Kingdom PoundHKD - Hong Kong DollarIDR - Indonesia RupiahMAD - Morocco DirhamMYR - Malaysia RinggitNZD - New Zealand DollarPHP - Philippines PesoRON - Romania New LeuSAR - Saudi Arabia RiyalSEK - Sweden KronaSGD - Singapore DollarTRY - Turkey New LiraZAR - South Africa RandOther currency
* / Bank Account Holder Name / * / Bank SWIFT Code:
* / Local/Routing Code:
*Note:If the bank account nameis different from the Legal name or Business Trade name, then kindly explain here why (or in a scanned and signed letter).
IBAN
Required for banks in European countries and few others.
* / Bank Account Number

Section 5: Intermediary bank information(If required)

Bank Name / Address
Intermediary Bank Account Number
Bank SWIFT Code / Bank Local/Routing Code / IBAN
Required for banks in European countries and few others.

Section 6: Authorization

Statement: I certify that the information provided in this document is correct and accurate, and authorize Intel’s Accounts Payable Department to initiate payments using the bank details provided in this form Section 4 (and in Section 5 if required).

* / Authorized Individual Name / Authorized Signature
* / Date
[Month/Day/Year]
Disclaimer: Intel makes no representations, warranties or assurances of any kind about the accuracy or completeness of the information provided in this document.
Intel Corporation |Payee Information Form / 1