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, encouraging existing vendors and new vendors to adopt ACH payment methods instead of paper checks. The document requires vendors to provide detailed banking information, contact details, and email addresses to set up electronic payment processing.

The form allows vendors to choose between being an OC Employee, Existing County Supplier, or New County Supplier, and to indicate whether they are submitting a new ACH application or updating existing information. Vendors must provide bank routing and account numbers, with options to use either a voided check or a bank letter/specification sheet for verification. The document notes that it may take one to two payment cycles before the first ACH payment is processed, and vendors are required to submit original, not emailed, forms to the Orange County Department of Finance.