EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Carl Pugh Park - Drainage Improvements
Solicitation number
25/26-041
Issued by
Clay County, Harold CDP, Florida

About this file

This is an Electronic Funds Transfer (EFT) Authorization Form from the Clay County Clerk of Court and Comptroller in Florida, related to the Carl Pugh Park Drainage Improvements project bid opportunity. The form is a standard authorization document that vendors and contractors must complete to receive electronic payment from Clay County. The form requires submission of bank account information including the financial institution name, account type (checking, savings, or other), routing/ABA number, and account number. The authorization allows Clay County's Comptroller Department and the specified financial institution to initiate electronic credits and, if necessary, debit entries and adjustments for any erroneous credits. Vendors and contractors must notify the Comptroller Department immediately if they close or change their bank account during the contract period.

The EFT Authorization Form remains in effect until the vendor submits written cancellation to the Comptroller Department. The form requires an authorized signature and date from the individual or business representative submitting it. For individuals uncertain about their complete EFT information, the form recommends contacting their financial institution directly, which can typically provide direct deposit letters or voided checks. For businesses and vendors, financial institutions can supply complete ACH/EFT information upon request. This form is a prerequisite document for participation in Clay County contracting and must be completed and submitted as part of the bidding process for the Carl Pugh Park Drainage Improvements project.

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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 .