EFT_FORM.pdf
PDF 418 KB Posted
- Attached to
- Omega Park CCUA Connection State and local contract opportunity
- Solicitation number
- 25/26-007
- Issued by
- Clay County, Miramar Beach CDP, Florida
About this file
The document is an Electronic Funds Transfer (EFT) Authorization Form from the Clay County Clerk of Court and Comptroller. The form is designed for individuals, businesses, or vendors to provide their banking information to enable electronic financial transactions with the county. The form requests key details including the account holder's name, contact information, financial institution, account type (checking, savings, or other), transit/routing number, and account number.
The authorization allows Clay County Comptrollers to initiate electronic credits and, if necessary, debit entries and adjustments for any credit entries made in error. The form emphasizes the importance of notifying the Comptroller Department immediately if the bank account is closed or changed. It provides guidance for individuals and businesses to verify their complete EFT information with their financial institution, suggesting obtaining a direct deposit/EFT letter or a voided check to ensure accuracy of the submitted banking details.
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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 .