Vendor_EFT_form,_FAQ_and_instructions_3_PG.pdf

EFT Enrollment Form for Vendors Read instructions prior to completing.

Section A - Vendor’s information Vendor name: Vendor Employer Identification Number (Required):

Vendor address Street: City: State/province: ZIP code/postal code:

Telephone number: (Required) Email address (Required):

Section B– Financial institution information Financial institution name:

Financial institution address Street: City: State/province: ZIP code/postal code:

Financial institution routing number: Type of account at financial institution Checking* OR Savings Personal* OR Business*

*Copy of preprinted voided check or bank verification letter required.

Vendor’s account number with financial Institution:

Location of account numbers are on bottom of your check:

Section C – Submission information Reason for submission:

New enrollment (Start) Change enrollment Cancel enrollment (STOP)

Important! Please read and sign before submitting.

This form is used to authorize Electronic Funds Transfer to a checking or savings account.

• Recovery of funds deposited in error – In the event an erroneous deposit occurs creating an overpayment, City of Kingman will reserve the right to debit your account accordingly.

Office use only

Vendor Number: Date processed: Initial:

City of Kingman Finance signature: Date:

I certify that I have read and understand the information contained in this form. I acknowledge that the origination of transactions to the authorized account must comply with provisions of Arizona and US law. I certify that I am authorized to enter into this agreement as the account holder.

Once completed and signed please send this form to:

City of Kingman, Finance Department, 310 N. 4th St., Kingman, Arizona 86401 or email to vendors@cityofkingman.gov

Printed name of authorize signer: ______________________________Title:_____________________

Authorized signature of person submitting enrollment: _______________________________________

CITY OF KINGMAN

310 N. 4TH STREET KINGMAN ARIZONA 86401 928.753.5561 WWW.CITYOFKINGMAN.GOV

Date:________________

Please return completed enrollment form to vendors@cityofkingman.gov If you have any further questions or need any assistance, please contact our accountant: Alicia Price - (928)-753-8106 - vendors@cityofkingman.gov mmiller Highlight swarner Sticky Note No typed signatures accepted. Please physically sign and scan back or digitally sign with timestamp.

Instructions for Vendors and Contractors

Instructions for EFT Enrollment Form.

Section A – Vendor’s information

Vendor’s name – Complete legal name of institution, corporate entity, practice or individual.

Vendor’s Federal Tax Identification Number (TIN) – A federal tax identification number also known as an Employer Identification Number (EIN), is used to identify a business entity.

Vendor’s address

• Street – The number and street name where a person or organization can be found.

• City – City associated with vendor address field.

• State/province – two character code associated with the state/province/region of the applicable country.

• ZIP code/postal code – System of postal-zone codes.

• Telephone number – Associated with contact person (required).

• Email address – An electronic mail address at which agency might contact the vendor (required).

• Street – The number and street name where a person or organization can be found.

• City – City associated with vendor address field.

• State/province – IS0 3166-2, two character code associated with the state/province/region of the applicable country.

• ZIP code/postal code – System of postal-zone codes.

• Financial Institution routing number – A 9-digit identifier of the financial institution where the vendor maintains an account to which payments are to be deposited.

• Type of account at financial institution – The type of account the vendor will use to receive EFT payments, e.g., checking or savings, personal or business.

• Vendor’s account number with financial institution – Vendor's account number at the financial institution to which EFT payments are to be deposited.

Section B – Financial institution information Financial Institution name – Official name of the vendor’s financial institution.

Financial institution address:

Section C – Submission Information Reason for submission:

• New enrollment (Start) – Mark this box for new enrollment or re-enrolling for EFT after a cancellation.

• Change enrollment – Mark this box to change any information. Includes changes in bank account (canceling current deposit and starting a new one) or contact information. Note: If changing only email or mailing address, Section C may be left blank.

• Cancel enrollment (Stop) – Mark this box to withdraw authorization for EFT. Cancellations require a three day turnaround.

• Recovery of funds deposited in error – In the event an erroneous deposit occurs creating an overpayment, the City of Kingman will reserve the right to debit your account accordingly.

• Authorized signature – The signature of an individual authorized by the vendor or its agent to indicate, modify or terminate an enrollment.

Please provide proof of authorized signer in the form of an official bank letter dated within 45 days, Corporate Resolution, Meeting Minutes, or Business Filing showing authorized agent.

• Depending on the payment cycle, it may take up to 30 days to set up EFT payment.

• Please attach proof of authorized signer and a copy of a voided preprinted check or official bank verification letter dated within 45 days including account name, routing number and account number. This information is required for all new accounts so that we can accurately verify the account numbers. (Deposit slips not accepted.)

• Return by secure email to: vendors@cityofkingman.gov

• Or return by mail to: City of Kingman, Attn: Vendors, 310 N. 4th St., Kingman AZ 86401

• For questions contact: Finance at 928-753-5561

• Retain a copy for your records.

When this form is complete:

ANSWERS TO FREQUENTLY ASKED QUESTIONS ABOUT THE

CITY OF KINGMAN ELECTRONIC FUNDS TRANSFER (EFT)

FOR CITY VENDORS

1. WHAT ARE THE BENEFITS OF ELECTRONIC FUNDS TRANSFER(EFT)? There are several advantages to EFT:

l Payments are more secure - Paper checks can be lost in the mail or stolen, but money deposited directly in your bank account is more secure.

l Payments arrive sooner--You don't have to wait for a check to arrive in the mail. Electronic payments are deposited directly into your bank account, saving days of waiting for checks to clear.

l You save time – Money deposited into your bank account is automatic. You save the time you used to spend at the bank depositing the check.

2. WHO SHOULD ENROLL? All vendors are encouraged to enroll in the program. It saves both entities time and money.

3. HOW QUICKLY WILL A PAYMENT BE DEPOSITED INTO MY ACCOUNT? Payments are deposited two-three business days after the date of issuance.

4. HOW WILL I KNOW WHEN THE PAYMENT IS IN MY BANK ACCOUNT? Email notifications will be sent out to the email you specify on your form. Please verify this information is correct, as it is the only notification you will receive showing payment. In addition, you may contact your bank directly or use online banking, mobile applications, and regular bank statements to confirm the deposit.

5. HOW WILL I KNOW WHAT THE PAYMENT IS FOR? EFT payment may include payment for several invoices. The information notification sent out via email is similar to the current check stubs which show invoice number and amount.

Again, please verify the best email for this information to be sent to.

6. WHAT IF THERE IS A DESCREPANCY IN THE AMOUNT WE REQUESTED AND THE AMOUNT WE RECEIVED?

Please contact our Finance department at 928-753-5561.

7. CAN EFTS BE CREDITED TO THE WRONG ACCOUNT? The vendor is responsible for submitting the correct information. The City of Kingman will not be able to ascertain if the vendor has supplied incorrect banking account information. If the City of Kingman receives notification that the EFT has been rejected, we will notify you to determine and correct the problem. In order to avoid delay of future payments in this instance, we would issue paper checks until the issue can be resolved.

8. WHAT MUST I DO IF I CHANGE MY BANK OR MY ACCOUNT NUMBER? Whenever you change any information, you must submit a new EFT Enrollment Form to the Finance Department indicating the type of change you are requesting. A copy of a voided check, or bank letter with the new account information must be included with your EFT Enrollment Form.

Mail correspondence to: City of Kingman, Finance Department, Attn: Alicia Price 310 N. 4th St. Kingman, Arizona 86401

E-mail: vendors@cityofkingman.gov.

9. CAN I CANCEL MY EFT ENROLLMENT? Vendors may request a cancellation by submitting a new form, and checking "cancel enrollment."

10. DO I NEED TO SEND SEPARATE EFT ENROLLMENT FORMS FOR EACH CITY AGENCY WITH WHICH I DO BUSINESS? No. One enrollment form is sufficient.

11. WHAT IF MY NAME, ADDRESS OR TAX ID # CHANGES? HOW DOES THIS AFFECT MY EFT? WHO SHOULD BE NOTIFIED? If your name, address or Tax ID # change, you must contact the Finance Department. You will need to submit a new form as well as a W9 if your name or Tax ID # change. If only your address needs to be changed, you do not need to submit a new EFT Enrollment Form.

12. WHO SHOULD COMPLETE AND SIGN THE FORM? The form should be filled out and signed by an officer of the company that has been granted access to the bank account.

13. WHAT DOCUMENTATION IS NEEDED FOR PROOF OF AUTHORIZED SIGNER? Proof is required in the form of a bank letter dated within 45 days, Corporate Resolution, Meeting Minutes, or any other legal documentation.

FAQ - EFT - Rev. 2.25.20

PLEASE DO NOT RETURN Q&A - THIS IS FOR YOUR USE