EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Moody Park Shade Sail Replacement
Solicitation number
25/26-091
Issued by
Clay County, Orlando City, Florida

About this file

This is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller in Florida. The form is designed for individuals, businesses, and vendors to authorize Clay County's Comptroller Department and their financial institution to initiate electronic credits and, when necessary, debit entries and adjustments related to contract payments. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors are instructed to notify the Comptroller Department immediately if they close or change their bank account during the contract period.

The form requires vendors to provide complete banking information, including the financial institution name, account type (checking, savings, or other), transit/ABA/routing number, and account number. Both individuals and businesses are directed to contact their financial institutions if they lack complete EFT information, with the option to obtain direct deposit or EFT letters or voided checks to verify account details. This form is a standard requirement for the Moody Park Shade Sail Replacement project, which involves the replacement of two thirty-foot tri-sail shade nets with new cable, hardware, and installation at Moody Avenue Park in Orange Park, Florida.

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Text version

Clay County Clerk of Court and Comptroller

EFT Authorization Form

Individual/Business/Vendor Name: (Please Print)

Phone Number:

Email:

I/We hereby authorize Clay County Comptrollers and the financial institution listed below to initiate electronic credits, and, if necessary, debit entries and adjustments for any credit entries in error. This authority will remain in effect until I cancel it in writing to the Comptroller Department. *Notify the Comptroller Department immediately if you close or change Bank Account*

Account Information:

Financial Institution:

Type of Account (please circle one): Checking Savings Other:______________

Transit / ABA / Routing #:

Account Number:

*Individuals: If you are unsure of your complete EFT information please contact your financial institution. In most cases, your financial institution can provide you with a direct deposit/EFT letter or a voided check.

Businesses/Vendors: Please check with your financial institution for your complete ACH/EFT information.

Authorized Signature:_______________________________ Date: ___________

File details come from the government source that posted it. Updated .