EFT_FORM.pdf

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 who wish to receive electronic payments from Clay County. Vendors must complete the form by providing their name, phone number, email address, and authorizing Clay County Comptroller's office and their designated financial institution to initiate electronic credits and debits as necessary. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors must immediately notify the Comptroller Department of any changes to or closure of their bank account to ensure uninterrupted payment processing.

The form requires vendors to provide complete banking information including the financial institution name, account type (checking, savings, or other), routing number, and account number. Individuals are advised to contact their financial institution for direct deposit or EFT letters and voided checks if unsure of their banking details, while businesses and vendors should verify their ACH/EFT information directly with their financial institution. The form must be signed and dated by an authorized representative before submission to Clay County. This form is a prerequisite for vendors bidding on the Clay County Pavement Assessment project, which seeks qualified firms to conduct a comprehensive Pavement Condition Survey and develop a Pavement Management Program for approximately 831 centerline miles of county-maintained paved roadways.