Supplier Registration Questionnaire 2023 (ENGLISH)

Supplier Registration Questionnaire
Company Information
* Supplier Company Name
* Select your location: (SELECT COUNTRY)

* Federal Tax Classification (required for US (Federal Tax Classification)
only for 1099)
* Tax Identification Number (TIN)
* Permanent Account Number (PAN - required
for India suppliers)
* Goods and Service Tax Identification Number

(GSTIN - required for India suppliers)
GST Compliance Rating (For India suppliers)
Is the vendor covered under the Composition

Scheme? (YES/NO - required for India suppliers)
Does your company have diversity status? If yes, provide the Diversity Certificate and select the type of Diversity Supplier
in the following field:
Type of Diversity Supplier Not Applicable - not a diversity supplier
Contact Information
* Primary Contact First Name (Given Name)
* Primary Contact Last Name (Family Name)
* Primary Contact Email
* Primary Contact Phone - Office
* Primary Contact Phone - Mobile

Accounts Receivable Contact Person - Full
Name
Accounts Receivable Contact Person - Email
Address
* Company Street Address
* Company Address City

* Company Address State/Province (required
for US and Canada suppliers)
* Postal Code (required for US and Canada
suppliers)
* State Code (required for India suppliers) (State Name) (State Code)
* Purchase Order Email (We recommend an
alias or distribution list, such as
"purchaseorders@company.com")
Payment Remittance Address
* Remittance Advice Email Address
CNX employee contact information
* Full Name
* Email Address
Supplier Registration Questionnaire
Payment Information
* Payment Method (SELECT PAYMENT METHOD)
* Payment Terms (based on contract terms) (SELECT PAYMENT TERMS)
* Invoice / Payment Currency (SELECT CURRENCY)
* Beneficiary/Bank Account Name
* Bank Name
* Bank ID/Code (BSB Code for Australia and NZ;
3-digit Bank Code for South Korea)
* Bank Code (Colombia) (SELECT Bank Code for Colombia)
* Direccion Bancaria (Uruguay)
* Numero do Banco (Brazil)

* Agency Code (Brazil/Colombia); Sucursal
Bancaria (Uruguay)
Bank Branch (if applicable)
Bank Address (if applicable)

* Bank Account / IBAN Number (required for
wire transfers)
* Bank Account Type (Colombia/Dominican (SELECT CA/SA Code for Colombia/Dominican Republic)
Republic)
* IFSC Code (India Only)
* Routing Number / SWIFT Code / BIC Code
(required for wire transfers)
Sample Cancelled Check for India
* CHECKLIST OF SUBMITTED SUPPORTING W9 for US only
DOCUMENTS PAN Card for Indiaonly
Invoice
BIR 2303 for PH only Diversity Certificate
only
* Declaration of Authority
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief, and
I undertake to inform you of any changes therein, immediately. In case any of the above information is found to
be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. Moreover, I read
and understand that I will be subscribing to the Concentrix Coupa Supplier Portal in order for my invoices to be
processed for payment. I acknowledge that if goods/services are provided to Concentrix without having an
approved purchase order in place, in advance, for those goods/services, I could experience payment delays or
non-payment for those goods/services. I have read, understand and agree to comply with the Concentrix Supplier
Code of Conduct that can be found at the following link: https://www.concentrix.com/supplier-code-conduct/
* Name Bryan Vince Lee
* Title / Position Associate Director, Legal Counsel
* Date 11/21/2023
* Signature
Once completed and signed, please scan and return this document via email to your
Concentrix Procurement point of contact.
Privacy
Concentrix is a technology-enabled global business services company specializing in customer engagement and improving business
performance. Any personal information provided by you on this form is being collected by Concentrix for business, accounting and
reporting purposes. The information has been provided voluntarily. If you do not provide it, Concentrix may be unable to order
supplies or make payments. The information will be securely stored.
If you have any questions, we invite you to contact the GLOBAL VENDOR MANAGEMENT TEAM
GLOBAL_VENDORMANAGEMENT@concentrix.com.
Country Tax ID Number Account Number
Nipti or Numri unik i identifikimit te

Albania 28-digit IBAN
subjektit (NUIS)
Clave Única de Identificación Tributaria

Argentina 22-digit Clave Bancaria Uniforme (CBU)
(CUIT)
Australia Australian Business Number (ABN) 9-digit account number
Austria EU VAT number 20-digit IBAN
Cadastro Nacional da Pessoa Jurídica

Brazil account number (no required number of digits)
(CNPJ)
Bulgaria EU VAT number 22-digit IBAN
Goods and Services Tax (GST) or

Canada account number (no required number of digits)
Harmonized Sales Tax (HST) number
China Business License Number account number (no required number of digits)
Colombia Cédula de Ciudadanía account number (no required number of digits)
Costa Rica Cédula Jurídica 22-digit IBAN
Croatia EU VAT number 21-digit IBAN

Centraal Registratie Informatie
Curacao account number (no required number of digits)
Belastingplichtige (CRIB)
Denmark EU VAT number 18-digit IBAN
Dominican Republic Registro Nacional del Contribuyente (RNC) account number (no required number of digits)
Egypt Egypt Tax Registration Number 29-digit IBAN
El Salvador Número de Identificación Tributaria (NIT) account number (no required number of digits)
France EU VAT number 27-digit IBAN
Georgia Tax Identification Number (TIN) 22-digit IBAN
Germany EU VAT number 22-digit IBAN
Greece EU VAT number 27-digit IBAN
Honduras Registro Tributario Nacional (RTN) account number (no required number of digits)
Hong Kong Tax Identification Number (TIN) account number (no required number of digits)
Hungary EU VAT number 28-digit IBAN
India Permanent Account Number (PAN) account number (no required number of digits)
Indonesia Tax Identification Number (TIN) account number (no required number of digits)
Ireland EU VAT number 22-digit IBAN
Italy EU VAT number 27-digit IBAN
Jamaica Taxpayer Registration Number (TRN) account number (no required number of digits)
Japan National Tax Agency Corporate Number 7-digit account number
Korea, Republic Of Business Registration Number account number (no required number of digits)
Numri Unik Identifikues or Tax

Kosovo 20-digit IBAN
Identification Number
Malaysia Tax Identification Number (TIN) account number (no required number of digits)
Mauritius Business Registration Number account number (no required number of digits)
Mexico Registro Federal de Contribuyentes (RFC) 18-digit CLABE
Netherlands EU VAT number 18-digit IBAN
New Zealand Business Number (NZBN) or

New Zealand Inland Revenue Department (IRD) or 10-digit account number
Goods and Services Tax (GST)
Nicaragua Registro Único de Contribuyente (RUC) account number (no required number of digits)
Philippines Tax Identification Number (TIN) account number (no required number of digits)
Poland EU VAT number 28-digit IBAN
Portugal EU VAT number 25-digit IBAN
Romania EU VAT number 24-digit IBAN
Saudi Arabia General Authority of Zakat and Tax account number (no required number of digits)
Accounting and Corporate Regulatory

Singapore Authority (ACRA) Registration Number or account number (no required number of digits)
Unique Entity Number (UEN)
Slovakia EU VAT number 24-digit IBAN
South Africa Tax Reference Number account number (no required number of digits)
Spain EU VAT number 24-digit IBAN
Sweden EU VAT number 24-digit IBAN
Taiwan VAT number account number (no required number of digits)
Thailand Business Registration Number account number (no required number of digits)
Tunisia Carte d'Identification Fiscale 24-digit IBAN
Turkey Tax Identification Number (TIN) 26-digit IBAN
United Arab Emirates Tax Registration Number 23-digit IBAN
United Kingdom UK VAT number 8-digit account number
Social Security Number (SSN) or Employer

United States account number (no required number of digits)
Identification Number (EIN)
Registro Unico Tributario number
Uruguay account number (no required number of digits)
(RUT)
Viet Nam Mã số doanh nghiệp (Business Code) account number (no required number of digits)
Bank Codes BIC/Swift Code
Not applicable 8-11 characters
6-digit BSB code 8-11 characters
3-digit bank code and 4-digit agency code Not necessary
9-digit ACH routing number which is a

combination of a zero (0) + 3-digit financial
Not applicable
institution number + 5-digit transit
(branch) number.
Not applicable XXXXCNXX
4-digit bank code Not necessary
Not applicable Not necessary

8-digit CodBancoDestino Not necessary

Not applicable IFSC
4-digit bank code and 3-digit branch code Not necessary
3-digit bank code 8-11 characters
2-digit ACH code 8-11 characters
2-digit clearing code 8-11 characters

6-digit BSB code 8-11 characters

9-digit local clearing code 8-11 characters
6-digit sort code 6-digit sort code
Not applicable 9-digit ACH routing number

3-digit bank code and 2-digit agency code Not necessary

Supplier Creation Required Documents
1. Global Helpdesk Ticket

2. Completed Supplier Registration Questionnaire (SRQ) in Excel or PDF format.
3. Procurement Regional Lead's approval
4. Nipti or Numri unik i identifikimit te subjektit (NUIS)

4. Clave Única de Identificación Tributaria (CUIT)


4. VAT Number should be entered in the SRQ

4. Cadastro Nacional da Pessoa Jurídica (CNPJ)


4. GST/HST should be entered in the SRQ

4. Business License Certificate

4. Cédula de Ciudadanía

4. Cédula Jurídica

4. Centraal Registratie Informatie Belastingplichtige (CRIB)


4. Registro Nacional del Contribuyente (RNC)

4. Egypt Tax Registration Number Card

4. Número de Identificación Tributaria (NIT)


4. Business Registration Form with TIN



4. Registro Tributario Nacional (RTN)


4. GST (Undertaking if there is no GST)
5. Scanned copy of PAN card
6. Scanned copy of cancelled check
7. Form 10F (for foreign suppliers)




4. Taxpayer Registration Number (TRN) document

2. Completed Supplier Registration Questionnaire (SRQ) in Excel.
4. Screenshot from the National Tax Agency website

4. Business Registration Form with Business Registration Number

4. Numri Unik Identifikues or tax identification number


4. Registro Federal de Contribuyentes (RFC)


4. New Zealand Business Number (NZBN) should be entered in the SRQ

4. Registro Único de Contribuyente (RUC)

4. BIR Form 2303 - Certificate of Registration
5. Any Government-Issued Document for Government Agencies




4. General Authority of Zakat and Tax Certificate

4. Accounting and Corporate Regulatory Authority (ACRA) Registration Number or
Unique Entity Number (UEN)

4. Business Registration Form with Tax Reference Number



4. Business Registration Form with VAT number


4. Carte d'Identification Fiscale


4. Business Registration Form with Tax Registration Number


4. Signed W9
5. Signed W8 (for foreign suppliers)
4. Registro Unico Tributario number
(RUT)

4. Business Registration Form with Mã số doanh nghiệp (Business Code)
5. Bank document to validate the beneficiary name

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Supplier Registration Questionnaire

* Supplier Company Name

* Select your location: (SELECT COUNTRY)

* Goods and Service Tax Identification Number

GST Compliance Rating (For India suppliers)

Is the vendor covered under the Composition

* Primary Contact First Name (Given Name)

* Primary Contact Last Name (Family Name)

* Primary Contact Email

* Primary Contact Phone - Office

* Primary Contact Phone - Mobile

* Company Address City

* Remittance Advice Email Address

CNX employee contact information

* Payment Method (SELECT PAYMENT METHOD)

* Payment Terms (based on contract terms) (SELECT PAYMENT TERMS)

* Invoice / Payment Currency (SELECT CURRENCY)

* Beneficiary/Bank Account Name

* Direccion Bancaria (Uruguay)

* Numero do Banco (Brazil)

Bank Address (if applicable)

* Name Bryan Vince Lee

* Title / Position Associate Director, Legal Counsel

Nipti or Numri unik i identifikimit te

Clave Única de Identificación Tributaria

Australia Australian Business Number (ABN) 9-digit account number

Austria EU VAT number 20-digit IBAN

Cadastro Nacional da Pessoa Jurídica

Bulgaria EU VAT number 22-digit IBAN

Goods and Services Tax (GST) or

Colombia Cédula de Ciudadanía account number (no required number of digits)

Costa Rica Cédula Jurídica 22-digit IBAN

Croatia EU VAT number 21-digit IBAN

Denmark EU VAT number 18-digit IBAN

Egypt Egypt Tax Registration Number 29-digit IBAN

France EU VAT number 27-digit IBAN

Georgia Tax Identification Number (TIN) 22-digit IBAN

Germany EU VAT number 22-digit IBAN

Greece EU VAT number 27-digit IBAN

Ireland EU VAT number 22-digit IBAN

Italy EU VAT number 27-digit IBAN

Japan National Tax Agency Corporate Number 7-digit account number

Numri Unik Identifikues or Tax

Netherlands EU VAT number 18-digit IBAN

New Zealand Business Number (NZBN) or

Poland EU VAT number 28-digit IBAN

Portugal EU VAT number 25-digit IBAN

Romania EU VAT number 24-digit IBAN

Accounting and Corporate Regulatory

Spain EU VAT number 24-digit IBAN

Sweden EU VAT number 24-digit IBAN

Taiwan VAT number account number (no required number of digits)

Tunisia Carte d'Identification Fiscale 24-digit IBAN

Turkey Tax Identification Number (TIN) 26-digit IBAN

United Arab Emirates Tax Registration Number 23-digit IBAN

United Kingdom UK VAT number 8-digit account number

Social Security Number (SSN) or Employer