EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Indigent Decedent Services
Solicitation number
25/26-105
Issued by
Clay County, Harold CDP, 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 vendors, businesses, and individuals to authorize Clay County's Comptroller Department and their designated financial institution to initiate electronic credits and, when necessary, debit entries for error corrections. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors must immediately notify the Comptroller Department if they close or change their bank account. The form requires submission of complete banking information, including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. Individuals may obtain EFT information from their financial institution via direct deposit letters or voided checks, while businesses and vendors should contact their institution for complete ACH/EFT details.

This form is associated with Clay County's Request for Bids for Indigent Decedent Services, wherein the county seeks an experienced funeral home to administer the Unclaimed Decedent Disposition Program and related services. The EFT form serves as a prerequisite for payment processing should the bidding vendor be selected for contract award. All bidder inquiries must be submitted through the designated Question and Answer tab, and bidders are prohibited from direct contact with county officials, board members, or evaluation committee members during the bid period, except through formal pre-bid conferences or scheduled presentations. The county reserves the right to reject all bids without cause and to waive non-material defects in submissions.

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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 .