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 (Washington Convention and Sports Authority - WCSA), which is a standard banking form used to establish electronic payment authorization. The form allows a business to set up direct deposit or electronic funds transfer capabilities with WCSA, permitting the organization to initiate credit and potential debit entries to the specified bank account.
The form requires the business to provide key financial and contact information, including company name, tax ID/EIN, bank account details (account and transit numbers), contact name, title, email, phone number, and requires attaching a voided check for verification. The authorization remains in effect until written termination is provided, giving WCSA and the designated depository reasonable opportunity to process the change. The form is designed to facilitate automated financial transactions between the business and WCSA, ensuring secure and efficient electronic payment processing.
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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 .