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VENDORS@GOV PASSWORD APPLICATION FORM

(1) (2) This form should be filled up by new vendors who wish to apply for Vendors@Gov password. It will take approximately 10 minutes to complete. AGD will only issue Vendors@Gov passwords to (i) foreign-registered vendors, or (ii) vendors without assigned Unique Entity Numbers (UEN). Local-registered vendors should access Vendors@Gov using SingPass. Completed forms should be mailed to the following address. Only original forms will be accepted for processing: AGD Vendors@Gov Administrator Accountant-Generals Department 100 High Street #06-01 The Treasury Singapore 179434 An email containing the Vendors@Gov password will be sent to successful applicants via the email address provided in Section B. Please allow up to 7 working days for processing.

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Section A Company Information Company Registration No. Company Name Company Address & Stamp

Payment Mode (Please indicate one of the following: Giro/Telegraphic Transfer/Bank Draft) Bank Account Number (Only if Payment Mode is GIRO or Telegraphic Transfer) Section B Personal Particulars of Company Representative Name of Representative Designation E-mail Address Telephone Number Section C Authorization by Company Management (To be completed by Finance Director/Chief Financial Officer or equivalent) Name of Authorizing Party Designation E-mail Address Telephone Number Signature & Date

Section D To be Completed by AGD Vendors@Gov Administrator Processed By / Date Processed