2020_ACH_FORM.pdf
PDF 54 KB Posted
- Attached to
- RFQ AED Medical Direction Services
- Solicitation number
- 25-S-013
- 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 or WCSA). The form is designed for businesses to authorize electronic financial transactions, specifically allowing WCSA to initiate credit and potential debit entries to a designated checking or savings account. The form requires completion of key banking details including depository name, branch, city, state, zip code, transit/ABA number, and account number.
The authorization remains in effect until written notification of termination is received by WCSA, providing the organization reasonable opportunity to process the change. The form requires the business representative to provide their name, title, contact information, and signature, with a specific instruction to attach a voided check for verification purposes. The document includes a logo for Events DC and is structured to facilitate automated financial transactions between the business and the organization.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .