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 enable vendors to receive payments electronically through ACH, replacing traditional paper check payments. The county encourages both existing and new vendors to adopt this payment method, with the form allowing suppliers to provide their banking details for direct electronic fund transfers.

The authorization form requires vendors to select their vendor type (OC Employee, Existing County Supplier, or New County Supplier) and complete sections for bank account information, including bank name, routing number, and account number. Vendors must provide supporting documentation, either a voided check or a bank letter with a bank representative's signature. The form also requests contact information, tax identification details, and email addresses for payment notifications. The document notes that it may take one to two payment cycles before the first ACH payment is processed, and no emailed applications will be accepted.