EFT_FORM.pdf

PDF 418 KB Posted

Attached to
CDBG - 2651 Sapp Lane Foundation Rehabilitation
Solicitation number
25/26-006
Issued by
Clay County, Miramar Beach 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 a Community Development Block Grant (CDBG) project for housing foundation and substructure rehabilitation services. The form is used to authorize Clay County Comptroller's office and a financial institution to initiate electronic credits and debit entries for vendor 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), transit/ABA/routing number, and account number. The form requires an authorized signature and date from the individual or business representative.

This authorization form is a standard administrative requirement for vendors contracted with Clay County to receive payment via electronic funds transfer rather than check payments. Vendors must notify the Comptroller Department immediately if they close or change their bank account. The form provides guidance for both individuals and businesses to obtain their complete EFT information from their financial institutions, with suggestions to request direct deposit letters or voided checks if documentation is needed. Submission of a completed EFT form is typically a prerequisite for contract award and commencement of payment processing.

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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 .