[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-283801-105":53,"doc-detail-283801-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","vendor-electronic-payment-form-supplier-instructions","Vendor Electronic Payment Form - Supplier Instructions","","Vendor Electronic Payment Form instructions enable suppliers to receive payments electronically via U.S.-based banks using ACH. The form collects required supplier identifiers, payee information, remittance address, and contact details, and requires submission of a voided check, bank statement, or bank authorization letter for account verification. It also captures financial institution details (routing number, account number, account type, remittance email) and records authorization acknowledgements for ACH compliance and payment adjustments, including tax and OFAC requirements.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/vendor-electronic-payment-form-supplier-instructions/283801/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/vendor-electronic-payment-form-supplier-instructions/283801.png","ImageObject",442,249,{"name":88,"@type":89},"Emma Wilson","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-22","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"How can suppliers receive payments electronically under this form?","Question",{"text":109,"@type":110},"Suppliers submit the form to begin or manage ACH payments through U.S.-based banks. Remittance information is delivered by email.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What documents are required for account verification?",{"text":114,"@type":110},"A copy of a voided check, a bank statement, or a bank authorization letter on bank letterhead signed by a bank representative must be provided.",{"name":116,"@type":107,"acceptedAnswer":117},"What information is required for a new add request?",{"text":118,"@type":110},"A new add request must include supplier required fields plus state agency contact information (agency name, contact name, email, and phone) for the business relationship.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},283801,1790666171,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","| NC Office of the State Controller Return to: [ncfsepay@osc.nc.gov](ncfsepay@osc.nc.gov)\u003Cbr>[Telephone: 919-707-0795](Telephone: 919-707-0795)[ ](Telephone: 919-707-0795)[www.osc.nc.gov](www.osc.nc.gov) | Supplier Electronic Payment Form\u003Cbr>New Add Request\u003Cbr>Change/Update Existing Account Inactivate Existing Account\u003Cbr>*Denotes a required field |\n| --- | --- |\n\nThe State of North Carolina offers payees the opportunity to receive payments electronically through U.S. based banks. In addition to having the funds deposited electronically, you will also receive remittance information by e-mail.  \nWe require you to submit a copy of a voided check, bank statement, or a bank authorization letter on bank letterhead  signed by a bank representative for account verification.   \n*TAX ID \\# or SSN             \n*PAYEE NAME    \n*REMITTANCE ADDRESS  \n\n|  |  |  |\n| --- | --- | --- |\n\n(AS PRINTED ON YOUR INVOICE)  \n*CONTACT  \nSTREET  \nCITY  \nNAME & TITLE  \nSUITE/ROOM \\#  \nSTATE ZIP CODE  \nPHONE NUMBER  \nNEW FINANCIAL INFORMATION  \n\n| *FINANCIAL INSTITUTION NAME: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| *NAME ON ACCOUNT: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| *NEW ROUTING NUMBER: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| *NEW ACCOUNT NUMBER: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| *ACCT TYPE: | Checking Savings |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| *REMIT E-MAIL ADDRESS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n\nNew add requests MUST include contact information for the state agency with which you are doing business.  \n\n| *North Carolina Agency Name: | *North Carolina Agency Contact Name: |\n| --- | --- |\n| *North Carolina Agency Contact Email Address: | *North Carolina Agency Contact Phone Number: |\n\nPRIOR FINANCIAL INFORMATION(only required for updates)  \n\n| FINANCIAL INSTITUTION NAME: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| NAME ON ACCOUNT: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| ROUTING NUMBER: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| ACCOUNT NUMBER: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| ACCT TYPE: |  | Checking Savings |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| REMIT E-MAIL ADDRESS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| * | ALL BOXES BELOW MUST BE REVIEWED AND CHECKED |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | I acknowledge that electronic payments to the designated account must comply with the provisions of [U.S. law](U.S. law), and the requirements of the Office of Foreign Assets Control (OFAC) . I affirm the entire amount of the payment will not be transferred to a foreign bank account. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | I authorize the Office of the State Controller to initiate ACH payments, and if necessary, adjustments for any ACH payments in error, to the financial institution and account identified on the attached certification document. This authority will remain in effect until I, the supplier cancel it in writing or the authority is terminated by the NC Office of the State Controller. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | I have attached a copy of a current voided check, current bank statement, or a bank authorization letter on bank letterhead signed by a bank representative. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| *PRINT NAME: |  |  |  |  |  |  |  |  |  |  | *DATE: |  |  |  |  |  |  |  |  |  |\n| *SIGNATURE: |  |  |  |  |  |  |  |  |  |  | *PHONE NUMBER: |  |  |  |  |  |  |  |  |  |\n\nRevised September 2023  \nInstructions  * Denotes a required field on the form  ","cbCaiafpgI5g62dk","https://ap.wps.com/l/cbCaiafpgI5g62dk","pdf",409958,"English","# New Add Request\n## Required supplier information\n## Financial institution details\n# Change/Update Existing Account\n## Prior financial information\n# Inactivate Existing Account\n## Authorization and acknowledgements","[{\"question\":\"How can suppliers receive payments electronically under this form?\",\"answer\":\"Suppliers submit the form to begin or manage ACH payments through U.S.-based banks. Remittance information is delivered by email.\"},{\"question\":\"What documents are required for account verification?\",\"answer\":\"A copy of a voided check, a bank statement, or a bank authorization letter on bank letterhead signed by a bank representative must be provided.\"},{\"question\":\"What information is required for a new add request?\",\"answer\":\"A new add request must include supplier required fields plus state agency contact information (agency name, contact name, email, and phone) for the business relationship.\"}]","Vendor Electronic Payment Form - Supplier Instructions | PDF",1789619876]