EFT_FORM.pdf
PDF 418 KB Posted
- Solicitation number
- 25/26-055
- 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, contractors, and individuals who receive payments from Clay County to establish direct deposit capabilities through electronic credits and debits. The form requires the vendor to provide their name, contact information, and complete banking details, including the financial institution name, account type, routing/ABA number, and account number. Authorization remains effective until the vendor provides written cancellation notice to the Comptroller Department. Vendors are advised to contact their financial institution for accurate EFT information, with options to obtain documentation through direct deposit letters or voided checks.
This form is a standard administrative requirement for the Clay County Fairgrounds Hurricane Roof Repairs project, which involves restoration work to Exhibit Hall 2 and Cattlemen's Arena. Contractors selected for this project must complete the EFT Authorization Form to facilitate payment processing by Clay County. The form serves as a prerequisite step in the contractor qualification and payment procedures, ensuring that all selected vendors can receive compensation through electronic transfer rather than traditional check payments. Vendors are responsible for notifying the Comptroller Department immediately if banking information changes or if an account is closed.
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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 .