Electtronic Funds Transfer EFT Form.pdf

This document is an Electronic Funds Transfer (EFT) Authorization Agreement from the Commonwealth of Massachusetts Office of the Comptroller, designed to establish or modify electronic funds transfer arrangements with Massachusetts state departments. The form allows organizations or individuals to enroll, change, or cancel existing EFT agreements, with sections for providing comprehensive banking and contact information. The form requires detailed input including account holder details, financial institution information, routing numbers, account types, and authorization signatures.

The form is structured across six parts, providing instructions for completing each section, with specific guidelines for entering account information, verifying vendor/customer details, and ensuring proper authorization. A key requirement is the need for supporting bank documentation, and the form emphasizes that all EFT requests are subject to a 5-day pre-certification period where accounts are verified by the qualifying financial institution before direct deposits can be initiated. The document is effective as of 8/6/2020 and must be completed with original signatures in black or blue ink, with no facsimile signatures accepted.