EFT_FORM.pdf
PDF 418 KB Posted
- Attached to
- Construction Manager at Risk (CMAR) for the Substance Use Disorder Recovery Center State and local contract opportunity
- Solicitation number
- 24/25-127
- Issued by
- Clay County, Harold CDP, Florida
About this file
This document is an Electronic Funds Transfer (EFT) Authorization Form issued by the Clay County Clerk of Court and Comptroller. The form is designed for individuals, businesses, and vendors to provide their bank account information to enable electronic credits and, if necessary, debit entries for the county's financial transactions. The form requires the participant to provide their name, contact information, and complete banking details, including the financial institution, account type (checking, savings, or other), routing number, and account number.
The form emphasizes the importance of accuracy and provides guidance for both individuals and businesses in completing the EFT information. Participants are advised to verify their banking details with their financial institution and can use a direct deposit/EFT letter or a voided check to confirm the information. The authorization remains in effect until canceled in writing, and the form includes a warning to notify the Comptroller Department immediately if the bank account is closed or changed. An authorized signature and date are required to validate the form.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Construction_Manager_at_Risk_(CMAR)_for_the_Substance_Use_Disorder_Recovery_Center.pdf | ||
| Owner-Direct_Purchase_Programs_Public_Works_Contracts.pdf | ||
| 2023-2024-150_FDCF_Fixed_Capital_Outlay_Grants_&_Aids_signed_-_signed.pdf | ||
| Appendix_II_for_2_CFR_Part_200.pdf | ||
| Certificate_of_final_payment.pdf | ||
| Chapter_8_Section_I_(1).pdf | ||
| Certificate_of_partial_payment.pdf | ||
| W-9_(2024).pdf |
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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 .