SF-3881 ACH Vendor/Miscellaneous Payment Enrollment Form

Pointers for Completing SF 3881 Form
To answer some of questions that vendors and agencies have raised when completing the vendor
enrollment form and prevent some of the mistakes that have occurred, the FMS is presenting
these additional pointers.
1. The Federal agency initiates the SF 3881 form to enroll its vendors to receive payment by
electronic funds transfer.
2. A vendor must complete a separate enrollment form (SF 3881) for each agency with which it
does business.
3. In the Agency Information Section, the term “AGENCY IDENTIFIER” means the acronym
by which the agency is known. For example, the “AGENCY IDENTIFIER” for the Financial
Management Service is FMS.
4. In the Payee/Company Information Section, it should be noted that the “TAXPAYER ID
NO.” may be used by the Government to collect and report on any delinquent amounts arising out
of the offerer’s relationship with the Government (31 U.S.C. 7701 (c) (3)).
5. The financial institution and the vendor should each keep a copy of the completed form.
6. The vendor should return the completed SF 3881 to the agency that initiated the form.

ACH VENDOR/MISCELLANEOUS PAYMENT
ENROLLMENT FORM

OMB No. 1510-0056
Expiration Date 06/30/93

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains paymentrelated information processed through the Vendor Express Program. Recipients of these payments should bring

this information to the attention of their financial institution when presenting this form for completion.
PRIVACY ACT STATEMENT
The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This
information will be used by the Treasury Department to transmit payment data, by electronic means to
vendor's financial institution. Failure to provide the requested information may delay or prevent the
receipt of payments through the Automated Clearing House Payment System.
AGENCY INFORMATION
FEDERAL PROGRAM AGENCY
AGENCY IDENTIFIER:

AGENCY LOCATION CODE (ALC):

ACH FORMAT:
CTX

CCD+
ADDRESS:

TELEPHONE NUMBER:

CONTACT PERSON NAME:

(

)

ADDITIONAL INFORMATION:

PAYEE/COMPANY INFORMATION
NAME:

SSN NO. OR TAXPAYER ID NO.

ADDRESS:

CONTACT PERSON NAME:

TELEPHONE NUMBER:
(

)

FINANCIAL INSTITUTION INFORMATION
NAME:

ADDRESS:

ACH COORDINATOR NAME:

TELEPHONE NUMBER:
(

)

NINE-DIGIT ROUTING TRANSIT NUMBER:
DEPOSITOR ACCOUNT TITLE:

DEPOSITOR ACCOUNT NUMBER:

LOCKBOX NUMBER:

TYPE OF ACCOUNT:
CHECKING

SAVINGS

LOCKBOX

SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL:

TELEPHONE NUMBER:
(

NSN 7540-01-274-9925

3881-102

AGENCY COPY

)
SF 3881 (Rev 12/90)
Prescribed by Department of Treasury
31 U S C 3322; 31 CFR 210

ACH VENDOR/MISCELLANEOUS PAYMENT
ENROLLMENT FORM

OMB No. 1510-0056
Expiration Date 06/30/93

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains paymentrelated information processed through the Vendor Express Program. Recipients of these payments should bring

this information to the attention of their financial institution when presenting this form for completion.
PRIVACY ACT STATEMENT
The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This
information will be used by the Treasury Department to transmit payment data, by electronic means to
vendor's financial institution. Failure to provide the requested information may delay or prevent the
receipt of payments through the Automated Clearing House Payment System.
AGENCY INFORMATION
FEDERAL PROGRAM AGENCY
AGENCY IDENTIFIER:

AGENCY LOCATION CODE (ALC):

ACH FORMAT:
CCD+

CTX

ADDRESS:

TELEPHONE NUMBER:

CONTACT PERSON NAME:

(

)

ADDITIONAL INFORMATION:

PAYEE/COMPANY INFORMATION
NAME:

SSN NO. OR TAXPAYER ID NO.

ADDRESS:

CONTACT PERSON NAME:

TELEPHONE NUMBER:
(

)

FINANCIAL INSTITUTION INFORMATION
NAME:

ADDRESS:

TELEPHONE NUMBER:

ACH COORDINATOR NAME:

(

)

NINE-DIGIT ROUTING TRANSIT NUMBER:
DEPOSITOR ACCOUNT TITLE:

DEPOSITOR ACCOUNT NUMBER:

LOCKBOX NUMBER:

TYPE OF ACCOUNT:
CHECKING

SAVINGS

LOCKBOX

SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL:

TELEPHONE NUMBER:
(

NSN 7540-01-274-9925

3881-102

PAYEE/ COMPANY COPY

)
SF 3881 (Rev 12/90)
Prescribed by Department of Treasury
31 U S C 3322; 31 CFR 210

ACH VENDOR/MISCELLANEOUS PAYMENT
ENROLLMENT FORM

OMB No. 1510-0056
Expiration Date 06/30/93

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains paymentrelated information processed through the Vendor Express Program. Recipients of these payments should bring

this information to the attention of their financial institution when presenting this form for completion.
PRIVACY ACT STATEMENT
The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This
information will be used by the Treasury Department to transmit payment data, by electronic means to
vendor's financial institution. Failure to provide the requested information may delay or prevent the
receipt of payments through the Automated Clearing House Payment System.
AGENCY INFORMATION
FEDERAL PROGRAM AGENCY
AGENCY IDENTIFIER:

AGENCY LOCATION CODE (ALC):

ACH FORMAT:
CCD+

CTX

ADDRESS:

TELEPHONE NUMBER:

CONTACT PERSON NAME:

(

)

ADDITIONAL INFORMATION:

PAYEE/COMPANY INFORMATION
NAME:

SSN NO. OR TAXPAYER ID NO.

ADDRESS:

CONTACT PERSON NAME:

TELEPHONE NUMBER:
(

)

FINANCIAL INSTITUTION INFORMATION
NAME:

ADDRESS:

TELEPHONE NUMBER:

ACH COORDINATOR NAME:

(

)

NINE-DIGIT ROUTING TRANSIT NUMBER:
DEPOSITOR ACCOUNT TITLE:

DEPOSITOR ACCOUNT NUMBER:

LOCKBOX NUMBER:

TYPE OF ACCOUNT:
CHECKING

SAVINGS

LOCKBOX

SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL:

TELEPHONE NUMBER:
(

NSN 7540-01-274-9925

3881-102

FINANCIAL INSTITUTION COPY

)
SF 3881 (Rev 12/90)
Prescribed by Department of Treasury
31 U S C 3322; 31 CFR 210

Instructions for Completing SF 3881 Form

1.

Agency information Section - Federal agency prints or types the name and address of the
Federal program agency originating the vendor/miscellaneous payment, agency identifier, agency
location code, contact person name and telephone number of the agency. Also, the appropriate
box for ACH format is checked.

2.

Payee/Company Information Section - Payee prints or types the name of the payee/company
and address that will receive ACH vendor/miscellaneous payments, social security or taxpayer
ID number, and contact person name and telephone number of the payee/company. Payee
also verifies depositor account number, account title, and type of account entered by your
financial institution in the Financial Institution Information Section.

3.

Financial Institution Information Section - Financial institution prints or types the name
and address of the payee/company's financial institution who will receive the ACH payment,
ACH coordinator name and telephone number, nine-digit routing transit number, depositor
(payee/company) account title and account number. Also, the box for type of account is checked,
and the signature, title, and telephone number of the appropriate financial institution official
are included.
Burden Estimate Statement

The estimated average burden associated with this collection of information is 15 minutes per respondent or recordkeeper, depending on individual circumstances. Comments concerning the
accuracy of this burden estimate and suggestions for reducing this burden should be directed to
the Financial Management Service, Facilities Management Division, Property and Supply Branch,
Room B-101, 3700 East-West Highway, Hyattsville, MD 20782 and the Office of Management and
Budget, Paperwork Reduction Project (1510-0056), Washington, DC 20503.