2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- COOLING TOWER REPLACEMENT SERVICES
- Solicitation number
- 25-S-030
- 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, in the District of Columbia. The form is designed to establish automatic deposit procedures for vendors and contractors conducting business with the authority. The document serves as a standardized template that captures essential banking information necessary for the authority to process electronic payments to contractors' designated financial institutions.
The form requires vendors to provide company name, EIN or Tax ID, depository information including bank name, branch location, routing number (transit/ABA), and account number. Vendors must specify whether deposits should be directed to checking or savings accounts and provide contact information including name, title, email, phone number, and signature. The authorization remains in effect until the contractor submits written termination notice, allowing WCSA and the depository reasonable time to process the request. A voided check must be attached to verify banking details and prevent payment errors or delays.
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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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