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 vendor payments through electronic means, with the county encouraging both new and existing vendors to accept ACH payments instead of traditional paper checks. The document outlines the process for vendors to set up or update their electronic payment information, emphasizing that original forms must be submitted and no emailed applications will be accepted.

The form requires vendors to provide comprehensive banking and contact details, including bank routing and account numbers, contact information, and tax identification. Vendors must choose between a voided check or a bank letter/specification sheet to verify their banking information. The form notes that it may take one to two payment cycles before the first ACH payment is processed, and vendors are instructed to provide at least one valid email address for invoice details. The document is signed by Kerry Gallagher, Commissioner of Finance, and includes contact information for the Orange County Department of Finance at 255 Main St., Goshen, NY 10924, with a phone number of 845-360-6666.