EFT_FORM.pdf

PDF 418 KB Posted

Attached to
Firefighter Gear Storage Shed Construction
Solicitation number
25/26-027
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, designed to facilitate electronic payment processing for vendors, businesses, and individuals conducting transactions with Clay County government. The form collects vendor banking information including financial institution details, account type, routing number, and account number to enable direct deposit of payments related to county contracts and services. Vendors must complete and submit the form to authorize Clay County's Comptroller Department to initiate electronic credits and, when necessary, debit entries for payment adjustments. The authorization remains valid until the vendor provides written cancellation notice to the Comptroller Department, and vendors are required to immediately notify the county of any changes to banking information or account closures.

The EFT form functions as a prerequisite administrative document for vendors bidding on or awarded contracts with Clay County, including the Firefighter Gear Storage Shed Construction project solicitation referenced in the related procurement. While the form itself contains no pricing terms, set-asides, or contract-specific requirements, its completion is typically mandatory for vendors seeking payment from the county. The form applies to all vendor categories—individuals, businesses, and organizations—and requires authorized signature and date of completion. Vendors uncertain about their EFT information are directed to contact their financial institutions for direct deposit letters or voided checks to obtain accurate routing and account numbers necessary for 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 .