2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Attached to
- IFB Surface Refinishing and Restoration Services
- Solicitation number
- 25-S-034
- Issued by
- District of Columbia
About this file
This is an Authorization Agreement for Automatic Deposits (ACH Credits) form issued by the Washington Convention and Sports Authority (WCSA), also known as Events DC, a District of Columbia entity. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a designated checking or savings account at a specified depository. The agreement remains in full force and effect until WCSA receives written termination notification from the account holder, allowing the organization and depository reasonable time to act on such notice.
The form requires completion of standard banking information including the depository name, branch location, transit/ABA number, and account number. Signatories must provide their name, title, email address for ACH notifications, phone number, and date of signature. A voided check must be attached to the completed authorization form to verify account details and facilitate the ACH process.
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Text version
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS)
COMPANY NAME: _____________________________________
EIN or Tax ID of the Business: ________________________________________
I (we) hereby authorize Washington Convention and Sports Authority (WCSA), hereinafter called COMPANY, to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (our) Checking Savings account (select one) indicated below and the depository named below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account.
DEPOSITORY
NAME BRANCH
CITY STATE ZIP
TRANSIT/ABA NO. ACCOUNT NO.
This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
NAME: __ TITLE: _______________________
Email for ACH Notification: ______________________ cc: ___________________________
PHONE #: __________________________________ DATE: ________________________
SIGNATURE:
*** ATTACH A VOIDED CHECK ***
File details come from the government source that posted it. Updated .