2020_ACH_FORM.pdf
PDF 54 KB Posted
- Solicitation number
- 25-S-057
- Issued by
- District of Columbia
About this file
This is an ACH (Automated Clearing House) authorization form for the Washington Convention and Sports Authority (WCSA), also known as Events DC, located in the District of Columbia. The form is designed to establish automatic deposit capabilities for contractors providing services to the organization. The form authorizes WCSA to initiate credit entries and, if necessary, debit entries and adjustments to a contractor's designated checking or savings account at their specified depository institution. Contractors must complete the form by providing their company name, EIN or Tax ID, depository information including the bank name, branch, routing number, and account number, along with contact information including name, title, email, phone number, and signature. A voided check must be attached to the form.
The authorization agreement remains in effect until WCSA receives written termination notice, giving the company and depository reasonable time to process the cancellation. This form facilitates payment processing for contractors engaged in services such as printing, mailing, and filing IRS 1094C and 1095C forms for the Walter E. Washington Convention Center and other WCSA facilities. The form allows contractors to designate a notification email address and carbon copy recipient for ACH transaction notices.
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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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