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 for new and existing vendors to switch from paper check payments to electronic ACH payments. The county requires vendors to complete this form to set up direct deposit for payments, with a clear instruction that original forms must be submitted and no emailed applications will be accepted.

The form requires vendors to provide comprehensive banking and contact information, including bank routing and account numbers, contact details, and tax identification information. Vendors must choose between submitting a voided check or a bank letter/specification sheet to verify banking details, and provide at least one email address where payment invoice details will be sent. The document notes that it may take one to two payment cycles before the first ACH payment is processed, and vendors are encouraged to contact the finance office if they have any questions about the process.