EFT_FORM.pdf
PDF 418 KB Posted
- Solicitation number
- 25/26-053
- 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 authorizes Clay County Comptroller and the vendor's designated financial institution to initiate electronic credits and debits for payment processing related to the Purchase and Installation of First Aid Metal Building at Clay County Fairgrounds project. The form requires vendors to provide their complete banking information, including the financial institution name, account type, routing number, and account number. The authorization remains in effect until the vendor submits written cancellation to the Comptroller Department, and vendors must notify the department immediately if they close or change their bank account.
The form is a standard administrative requirement for vendors conducting business with Clay County. Both individuals and businesses are directed to verify their complete EFT information with their financial institution, with individuals advised to request direct deposit or EFT letters or provide voided checks, and businesses instructed to obtain ACH/EFT information directly from their banks. Completion of this form is necessary for the county to process electronic payments to contractors selected for the first aid building project at the Clay County Fairgrounds located in Green Cove Springs, Florida.
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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 .