EFT_FORM.pdf
PDF 418 KB Posted
- Solicitation number
- 26/27-003
- 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 for vendors and contractors conducting business with Clay County. The form authorizes Clay County's Comptroller Department and the vendor's designated financial institution to initiate electronic credit deposits and, if necessary, debit entries and adjustments for erroneous credits. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department. Vendors must provide complete banking information including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. The form requires an authorized signature and date. Vendors are instructed to contact their financial institutions for complete ACH/EFT information if needed, with individuals advised that most institutions can provide direct deposit letters or voided checks, and businesses directed to verify ACH/EFT details directly.
Vendors must notify the Comptroller Department immediately if they close or change their bank account to ensure uninterrupted payment processing. This form is a prerequisite for participation in Clay County contract opportunities, including the Public-Private Partnership (P3) for the Clay County Regional Sports Complex Expansion. Submission of the EFT Authorization Form enables Clay County to process vendor payments electronically and efficiently while maintaining compliance with the county's payment procedures and financial controls.
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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 .