ACH form.pdf

This document is an Electronic Funds Transfer (EFT) & Automated Clearing House (ACH) Authorization Form from the Orange County Department of Finance, located in Goshen, New York. The form is designed to facilitate vendors transitioning from paper checks to electronic payments, with the county strongly encouraging existing and new vendors to accept ACH payments. The document outlines the process for vendors to set up direct deposit or electronic payment methods, requiring complete original forms to be submitted to the finance department.

The form requires vendors to provide comprehensive banking and contact information, including bank routing and account numbers, contact details, tax identification, and email addresses for payment notifications. Vendors must choose between submitting a voided check or a bank letter/specification sheet to verify account details, with a note that it may take one to two payment cycles before receiving the first ACH payment. The form emphasizes that no emailed applications will be accepted, and vendors must submit original hardcopy documents to complete the enrollment process for electronic payments.