2020_ACH_FORM_(2).pdf
PDF 54 KB Posted
- Attached to
- RFP- SOCIAL AND DIGITAL MEDIA SERVICES
- Solicitation number
- 25-S-020
- Issued by
- District of Columbia
About this file
This document is an Authorization Agreement for Automatic Deposits (ACH Credits) issued by Events DC (the Washington Convention and Sports Authority, WCSA). The form allows a business to authorize WCSA to initiate electronic credit and debit entries to a specified bank account, with the ability to make adjustments for any erroneous credit entries.
The form requires the business to provide key financial and contact information, including the company name, tax ID, bank account details (checking or savings), depository information, and contact details such as name, title, email, phone number, and signature. A voided check must be attached to validate the bank account information. The authorization remains in effect until the company provides written notification of termination, giving WCSA and the depository a reasonable opportunity to process the change.
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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 .