EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Moccasin Slough Boardwalk
Solicitation number
25/26-043
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, related to the Moccasin Slough Boardwalk capital improvement project. The form enables vendors and contractors to authorize Clay County's Comptroller Department and their designated financial institution to initiate electronic credit transfers for payments. 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 from the individual or business representative completing the authorization.

Vendors and contractors responding to the Moccasin Slough Boardwalk Request for Bids must complete and submit this EFT form as part of their bid documentation to ensure they can receive electronic payments from Clay County upon contract award. Vendors are advised to obtain their complete EFT information directly from their financial institutions, with individuals able to request direct deposit letters or voided checks and businesses consulting their institutions for ACH/EFT details. The form emphasizes that vendors must immediately notify the Comptroller Department if their bank account is closed or changed to prevent payment delays or errors.

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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 .