(Page 1/7)
Self-Defining Document
Section 1 -- Supplier Master Record
1.0 Identification Representative of ___________________________________
You are in business of …(mark all applied) IT______________ Chemical Industry
Electronic Industry Trading House Hardwares
Equipment Manufacturing Tooling/Fabrication Consultant/Services (circle one)
Mfg of __________________ Construction Others
1.a Company Website :
Company Name
Division Subsidiary of
Home Office Street Address
City State Zip Country
Telephone No. Key Contact
Fax No. E-mail
1.b Payment/Remit to Address
Address
City State Zip Country
Telephone A/R Person to Contact
Fax A/R Contact e-mail
1.c For Electronic Funds Transfer Use:
Bank Name Checking or Savings Account
Bank Transit Number (ABA#) Swift Code Reference/Roll #
Bank Account Number Currency
Bank Address
1.d Work History
Have you done work with Western Digital before? (Also known as Read Rite, Komag)
NO
YES If yes, please specify:
Have you done work for the HDD Industrial before?
NO
YES If yes, please specify:
Please list related projects presently working on or completed by your firm within last four (4) years.
Title of Project Status In progress Year Completed :
Title of Project Status In progress Year Completed :
Title of Project Status In progress Year Completed :
Revision Date : Apr 01'14