EFT_FORM.pdf

PDF 418 KB Posted

Attached to
CDBG-334 Gano Avenue Cleaning Services
Solicitation number
24/25-100
Issued by
Clay County, Orlando City, Florida

About this file

The document is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller. This form allows individuals, businesses, or vendors to authorize electronic credit and debit transactions with the county's financial systems. The form requires the completion of key information including the account holder's name, contact details, financial institution, account type, routing number, and account number.

The form provides instructions for both individuals and businesses to verify their banking information, recommending contact with their financial institution to obtain complete EFT details. The authorization remains in effect until cancelled in writing, and the form includes a warning to notify the Comptroller Department immediately if the bank account is closed or changed. While this specific form is not directly related to the CDBG-334 Gano Avenue Cleaning Services contract opportunity, it appears to be a standard administrative document that would be part of the vendor registration or payment process for contractors working with Clay County.

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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 .