Domestic vendor creation / amendment form  Clear Form
Please use this form to register Australian Domestic bank details with DFAT. 
Please complete al  sections of this form.  If a question does not apply to you, write N/A. 
If you have any questions about this form or you need help completing it, contact Financial Operations on 02 6261 1157 
or xxxxxxxx@xxxx.xxx.xx   
DFAT Agreement Manager to complete: (Complete this section before sending form to the supplier) 
Administered or Departmental funding?  Please Select
DFAT Contact Name: 
Create or amend vendor?  Please Select
Old Account number (if amendment): 
Section 1: Supplier details 
1.
Business or individual name
2.
ABN
If you do not hold an ABN, please complete and provide the “Statement by supplier form” 
3.
Industry type Please Select
4.
Do you identify as a ‘smal  business’ (please tick)? Yes
  No  
5.
Address
Street Address: 
Suburb: 
 State: 
Postcode: 
6.
Contact details
Business contact person: 
Telephone: 
Email address: 
Fax: 
Section 2: Financial institution details 
7.
Do you accept payment via Credit Card?  
If so, is there an additional charge and how much?
8.
I,                       
    , in my capacity as
hereby authorise DFAT to 
direct payments for goods and/or services to the fol owing account:
9.
Account name
10.
Bank name and branch
BSB Code 
- 
 Account number 
Please note, a signature is not required when 
this form completed and emailed by the 
supplier directly to xxxxxxxx@xxxx.xxx.xx 
Date/Signature of authorised representative 
Submit

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Document Outline

• Domestic vendor creation / amendment form
• Old Account number (if amendment):
• Create or amend vendor?
• Section 1: Supplier details
• 1. Business or individual name
• Section 2: Financial institution details
• 7. Do you accept payment via Credit Card?
• 8. I,                        , in my capacity as        hereby authorise DFAT to direct payments for goods and/or services to the following account:
• 9. Account name

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