ACH form2.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, with the county strongly encouraging existing and new vendors to accept ACH payments instead of paper checks. The document outlines the process for vendors to provide their banking information and authorize the county to initiate electronic credit and debit entries.

The form requires vendors to select their status (OC Employee, Existing County Supplier, or New County Supplier) and provide detailed information including contact details, bank account information, and email addresses. Vendors must submit either a voided check or a bank letter/specification sheet to process the request, with a note that it may take one to two payment cycles before receiving the first ACH payment. The form emphasizes that no emailed applications will be accepted, and original forms must be submitted to the Orange County Department of Finance.