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) from Events DC, the Washington Convention and Sports Authority (WCSA). The form is designed for businesses to authorize electronic financial transactions, allowing WCSA to initiate credit and debit entries to the designated bank account. The document provides spaces for the business to input critical financial and contact information, including company name, tax ID, bank details, account type, and contact information.
The form requires the business to attach a voided check and provides a mechanism for the company to make direct electronic deposits or corrections to financial transactions. It includes provisions for the authorization to remain in effect until written termination is provided, ensuring a standardized process for financial interactions between WCSA and the participating business. The form is structured to capture essential banking and contact information while providing a clear, professional mechanism for electronic financial transfers.
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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 ***
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