ACH form.pdf

The document is an Electronic Funds Transfer (EFT) & Automated Clearing House (ACH) Authorization Form from the Orange County Department of Finance in Goshen, New York. The form is designed for new and existing vendors to set up electronic payment methods for doing business with Orange County, with a focus on transitioning from paper checks to direct bank deposits. The form allows vendors to provide their banking details, contact information, and authorize the county to initiate credit or debit entries for payment processing.

The form requires vendors to select their status (OC Employee, Existing County Supplier, or New County Supplier) and indicate whether they are submitting a new ACH application or updating existing information. Vendors must provide complete bank details, including bank name, routing/ABA number, and account number, and choose between submitting a voided check or a bank letter/specification sheet. The document notes that it may take one to two payment cycles before the first ACH payment is received, and emphasizes that no emailed applications will be accepted. The form must be completed with original signatures and returned to the Orange County Department of Finance.