ACH_Form_(Rev._2011)_(12)_(3)_(1).pdf

This document is an Authorization Agreement for Automatic Deposits (ACH Credits) issued by the Washington Convention and Sports Authority (WCSA). The form is designed for a business to authorize the WCSA to initiate electronic credit or debit entries to a specified bank account, with provisions for correcting any entries made in error.

The form requires the company to provide its name, EIN/Tax ID, banking details including depository name, branch, city, state, ZIP code, transit/ABA number, and account number. The authorization remains in effect until written notification of termination is received, and the document requires the account holder's signature and requests a voided check to be attached. The form also includes fields for the signatory's name, title, and email address for payment notifications.