ENCLOSURE D-Banking Information Sheet.pdf

This document is a Vendor ACH Authorization Form for Brookhaven National Laboratory, managed by Brookhaven Science Associates, LLC under contract with the U.S. Department of Energy. The form is designed to capture vendor banking information to enable electronic payments through the Automated Clearing House (ACH) system. The form requires vendors to provide their company details, including vendor/company name, vendor number, tax ID number, and specific banking information such as financial institution, routing/transit number, and checking account number.

The authorization section allows the vendor to grant Brookhaven National Laboratory permission to initiate credit entries or correcting entries to the specified bank account. The authorization remains in effect until written notification is received to terminate or modify it, in compliance with NACHA (National Automated Clearing House Association) laws. The form requires an authorized representative's signature, contact information, and date to validate the banking authorization.