ACH form.pdf

This 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 to enable vendors to receive payments electronically for county contracts, including the Safe Resident Handling Equipment opportunity for the Valley View Center for Nursing Care and Rehabilitation. The document requires vendors to provide comprehensive banking and contact information to set up direct payments, with a note that it may take one to two payment cycles before receiving the first ACH payment.

The form emphasizes the county's preference for electronic payments and provides options for new and existing county suppliers to update or establish ACH payment methods. Vendors must complete sections detailing their company information, bank account details, and select either a voided check or bank letter for verification. The document specifies that original forms are required and cannot be submitted via email, and includes fields for selecting account type (checking or savings), providing bank routing and account numbers, and listing contact email addresses for invoice details.