AXESS OPERATIONS DE MEXICO S DE RL DE CV

VENDOR REGISTRATION FORM

GENERAL INFORMATION

VENDOR COMMERCIAL NAME

VENDOR LEGAL NAME

RFC / TAX ID
EMPLOYER SOCIAL SECURITY NUMBER
(FOR MX)

COUNTRY OF TAX RESIDENT

TAX ADDRESS

BUSINESS ADDRESS OR BRANCH/IN

CASE DIFFERENT THAN TAX ADDRESS

WEB SITE

VENDOR CONTAC INFORMATION

COMMERCIAL CONTACT POSITION

OFFICE PHONE MOBILE

EMAIL

BILLING& FINANCE CONTACT POSITION

OFFICE PHONE MOBILE

EMAIL

COMPANY INFORMATION (IN CASE OF COMPANY)

DATE OF INCORPORATION

PUBLIC REGISTRATION NUMBER

TYPE OF CORPORATION

NAME OF LEGAL REPRESENTATIVE

POA # FOR LEGAL REPRESENTATIV

STOCKHOLDERS (FOR NON PUBLIC ENTITIES):*

NAME EQUITY %

*PROVIDE CORPORATE LEGAL STRUCTURE IDENTIFYING THE ULTIMATE PARENT COMPANY

 DETAILS OF PRODUCTS AND SERVICES
DAYS OF CREDIT DAYS CURRENCY

SPECITY THE TYPE OF SALES TO AXESS:

PRODUCT SERVICES BOTH

DESCRIPTION OF PRODUCTS OR SERVICES OFFERED

TAX CATEGORIES CODES USED FOR TAX INVOICE(ONLY MX VENDORS)

SERVICES CONSIDER THE USE OF PERSONNEL AT CLIENT LOCATION Y/N YES NO

PERSONNEL DIRECTLY HIRED UNDER VENDOR Y/N YES NO
IN CASE ABOVE ANSWER IS "N", PLEASE INDICATE SUBCONTRACT E
EMPLOYER SOCIAL SECURITY NUMBER*

*Provide copy of Social Security (IMSS) Employer registration

BANK PAYMENTS DETAIL:

BANK NAME
ACCOUNT NUMBER
CLABE (FOR MEXICO ACCOUNTS
SWIFT OR BIC:
CURRENCY

Should attach Bank statement under name of vendor for the reported Bank account

VENDOR REFERENCES

REFERENCE NAME CONTACT PHONE EMAIL

1
2
3

COMMUNICATION WITH AXESS

ARE YOU ALREADY SELLING YOUR PRODUCTS/SERVICES TO AXESS IN OTHER REGION YES NO

IF YES PLESE SPECIFY YOUR RELATED PARTY AND AXESS ENTITY

HAVE YOU BEEN REQUESTED/QUOTED FOR YOUR PRODUCT/SERVICES BY AXESS: YES NO

VENDOR WAS CONTACTED BY : POSITION

DATE OF CONTACT QUOTE# DATE

ARE YOU REFERED BY OUR CLIENTS/VENDORS TO SELL PRODUCTS OR SERVICES TO AXESS: YES NO

AXESS´S CLIENT/VENDOR REFENCE CONTACT

IF HAVE A PO NUMBER PLESE INCLUDE POSITION

IN CASE OF NEW VENDOR OFFERING SERVICES TO AXESS INDICATE IF YOU HAVE ANY CONTACT TO AXESS PERSONEL:

YES NO

POINT OF CONTACT TO AXESS : POSITION

COMMERCIAL/MARKETING REPRESENTAT

PHONE OF CONTACT EMAIL

Signatures in Next page

 SIGNATURES

VENDOR LEGAL REPRESENTATIVE VENDOR CONTACT (SUBMITING THIS REGISTRATION)

NAME: NAME:
DATE DATE:
POSITION POSITION:

EXCLUSIVE FOR AXESS VENDOR REQUESTOR

VENDOR REQUESTED BY:

NAME:
DATE

POSITION
Signature

TYPE/SCOPE OF SERVICES
REQUIRED (JUSTIFICATION)

WO ASSIGNED

VENDOR REGISTRATION APPROVAL

NAME:

DATE
POSITION
Signature

EXCLUSIVE FOR FINANCE AXESS DEPARTMENT

VENDOR REGISTRATION DATE VENDOR SYSTEM ASSIGNED

REGISTERED BY

POSITION

PAYMENT TERMS
Signature

REF. DOCUMENTSO ADJUNTOS MX INT Y/N COMMENTS

1 FORMATO DE ALTA FIRMADO POR REP LEGAL Y CONTACTO PROVEEDOR X X
2 ACTA CONSTITUTIVA X X
2 COMPROBANTE DE DOMICILIO CON MENOS DE UN MES ANTIGUEDAD X X
3 PODER DEL REPRESENTANTE LEGAL X X
4 COPIA DE IDENTIFICACION REPRESENTANTE LEGAL X X
5 COPIA DE IDENTIFICACION DEL CONTACTO X X
6 CONSTANCIA SITUCION FISCAL DEL MES DE REGISTRO X
7 OPINION DE CUMPLIENTO D-32 X
8 OPINION DE CUMPLIMIENTO IMSS X
9 OPINION DE CUMPLIMIENTO INFONAVIT X
10 CARTA MANIFESTACION DATOS BANCARIOS (ORIGINAL FIRMADA POR REP. LEGAL, Y X X
SELLADA POR LA EMPRESA QUE INCLUYA DATOS BANCARIOS, NUM CUENTA, CLABE)
11 CARATULA ULTIMO ESTADO DE CUENTA BANCARIO A NOMBRE DE LA EMPRESA X X
12 CERTIFICADO DE RESIDENCIA FISCAL X
13 ÚLTIMA DECLARACIÓN ANUAL DE IMPUESTOS X X
14 W-9 PARA PROVEEDORES AMERICANOS X
REF. DOCUMENTS TO BE ATTACHED: MX INT Y/N COMMENTS
1 AVL FORM SIGNED BY LEGAL REPRESENTATIVE AND VENDOR CONTACT X X
2 DEEM OF INCORPORATION X X
2 RECEIPT FOR ADRESS WITH LESS THAN A MONTH X X
3 LEGAL REPRESENTATIVE POA X X
4 COPY OF ID OF THE LEGAL REPRESENTATIVE X X
5 COPY OF ID OF THE MAIN CONTACT X X
6 TAX ID FOR CURRENT MONTH X
7 TAX COMPLIANCE FORM D-32 X
8 SOCIAL SECURITY (IMSS )COMPLIANCE FORM X
9 INFONAVIT COMPLIANCE FORM X
10 BANK DETAIL LETTER (ORIGINAL SIGNED AND STAMP BY LEGAL REP. INCLUDING X X
CLABE, INTERNATIONAL WIRE INFORMATION).
11 BANK STATEMENT FRONT SHEET UNDER NAME OF VENDOR X X
12 TAX RESIDENT CERITIFICATE X
13 LAST ANNUAL TAX RETURN X X
13 W-9 FOR USA VENDORS X