EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Lake Geneva Restoration Project
Solicitation number
25/26-013
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. The form is designed for vendors, businesses, and individuals who contract with Clay County to establish direct deposit payment arrangements. The authorization permits Clay County's Comptroller Department and the vendor's designated financial institution to initiate electronic credits and, if necessary, debit entries to correct erroneous credit transactions. The form requires vendors to provide their banking information, including the financial institution name, account type, routing number, and account number. Authorization remains valid until the vendor submits written cancellation to the Comptroller Department. Vendors are instructed to notify the Comptroller Department immediately if they close or change their bank account to prevent payment delays or processing errors.

The form serves as a prerequisite documentation requirement for payment processing on the Lake Geneva Restoration Project, a Clay County initiative seeking qualified contractors to remove trees measuring four inches or greater in diameter from the exposed lakebed during Phase I. Completion of the EFT Authorization Form is standard administrative procedure for all Clay County contractors and vendors receiving compensation through electronic payment methods. Individuals uncertain of their banking details are advised to contact their financial institution directly or provide a voided check or direct deposit letter as reference documentation.

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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 .