2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- URBAN BEEKEEPING SERVICES
- Solicitation number
- 25-S-050
- 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 authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a specified checking or savings account at a designated depository. The agreement remains in full force and effect until WCSA receives written notification of termination, provided such notification allows WCSA and the depository reasonable time to process the request.
The form requires the contractor to provide company name, EIN or Tax ID, depository information including branch location, transit/ABA number, and account number. The signatory must include their name, title, email address for ACH notifications, phone number, and signature date. A voided check must be attached to the form to verify banking information. This document is a standard payment mechanism for contractors working with WCSA and does not contain specific contractual terms, pricing, or service requirements related to the Urban Beekeeping Services solicitation.
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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 .