Supplier Registration Screen

Office of the Comptroller of the Currency (OCC)

Company Legal Name: *

Company DBA Name:

Company DUNS Number: *

Is company registered with SAM? (formerly CCR): *

Yes

No

Please enter your company’s five primary NAICS (North American Industry Classification System) Codes (at least 1 is required): *

Please enter up to an additional 15 NAICS Codes for your company (optional):

Street Address: *

Suite:

City: *

State: *

Zip Code: *

Company Phone Number: *

Website URL:

Legal Entity Type: *

Business Classification (choose all that apply) *

Capability Statement: *
3000 characters remaining

Federal Contracting Vehicles (e.g. GSA IT Schedule 70; NIH NITAAC CIO-SP3; NASA SEWP; etc.):

Contact Name: *

Title: *

Contact Phone Number: *

Email: *

OMB Control No.:

1557-0316

Expiration Date:

12/31/2022