2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- ATM SERVICES
- Solicitation number
- 25-S-022
- 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, located in the District of Columbia. The form establishes the procedural mechanism for the organization to process vendor payments through automated clearing house transactions. The agreement authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to correct erroneous transactions to the vendor's designated checking or savings account at a specified financial institution. The authorization remains in effect until WCSA receives written termination notification, providing both the company and the depository with reasonable time to process the cancellation.
The form requires vendors to provide essential banking information including the depository name, branch location, transit/ABA routing number, and account number. Vendors must also supply their company name, employer identification number or tax identification number, contact person's name and title, email address for ACH notifications, phone number, and signature authorization. The form explicitly requires vendors to attach a voided check to verify account information and banking credentials. This document is a standard administrative requirement for vendors selected to provide services to WCSA and facilitates efficient payment processing for contracted services.
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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 .