eft form.pdf

US ARMY CORPS OF ENGINEERS

ELECTRONIC PAYMENTS/DIRECT DEPOSIT

1. The Debt Collection Improvement Act of 1996 provided that Federal payments shall be made by electronic funds transfer (EFT). The Corps issues electronic corporate payments though the Automated Clearing House (ACH) network using the Cash Concentration or Disbursement Plus Addendum (CCD+) payment format. Instead of receiving checks, you will have payments directly deposited into your checking or savings account.

2. The benefits of receiving payments electronically are no lost or stolen checks, no deposit delays, prompt availability of funds, fully traceable payments, and decrease in fraud.

3. EFT/Direct Deposit payments are available for vendors who have active contracts with the Corps sites within the Continental United States. Corps travelers working for these sites should also sign up for EFT.

4. Attached is Form UFC-DISB-4 with instructions that can be used by both vendors and travelers to sign up for Corps EFT payments.

5. Point of contact for questions is Michael Rye, commercial 901-874-8543, DSN 882-8543, Corps email address; t0rmfmtr@cefc.fc, Internet address;

Michael.T.Rye@usace.army.mil.

mailto:t0rmfmtr@cefc.fc mailto:Michael.T.Rye@usace.army.mil

INSTRUCTIONS FOR COMPLETING FORM UFC-DISB-4

1. Vendors and/or travelers should indicate if this is an add as a new Direct Deposit to be set up or a change or cancellation. USACE employees already on payroll Direct Deposit who have not completed a travel form should mark ADD.

2. Include the Corps of Engineers District name (example: Savannah) or EROC (example: K6) that wrote the contract authorizing payment. If more than one District issued contracts, prepare a separate form for each District.

3. Include the name or Company as it appears on the invoice. If the contract was written to Bill and Betty Smith, the bill and Direct Deposit form should include both names not Bill Smith.

4. This address should be the physical address of the business.

5. The city and state that match the physical address.

6. The mailing address should include any and all Remit to/payment addresses that are different from the physical address. (If more space is needed, include an attachment page with all addresses listed). This is VERY IMPORTANT since we load the routing and bank account number on each payment address.

7. Include daytime phone number in case there are questions concerning the completed form.

8. Check if the bank account number furnished is a checking account.

9. Check if the bank account number furnished is a savings account.

10. Include bank account number, one number in each slot. This number can be found on the front of the check.

11. The full name of the bank for the account.

12/13. An accurate address for the bank.

14. The routing number for the bank. It is located on the face of the check.

This is always a nine digit NUMBER. Enter one number in each space.

15. Depositor account title is the name registered with the bank on the bank account.

16. For businesses include the IRS tax ID number. For an individual use the social security number.

17. Businesses should have a signature of an officer of the company.

Individuals should sign. If the Direct Deposit form/contract is written in the name of Bill and Betty Smith, both individuals should sign.

18. Date of the authorization.

DIRECT DEPOSIT AUTHORIZATION FORM

PRIVACY ACT STATEMENT

The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This information will be used by the Treasury Department to transmit data, by electronic means to vendor’s financial institution. Failure to provide the requested information may delay or prevent the receipt of payments through the Automated Clearing House Payment System.

I hereby authorized U. S. Army Corps of Engineer, hereinafter called USACE, to initiate direct deposit credit entries to my (our) account indicated below and the financial institution named below, hereinafter called DEPOSITORY, to credit the same to such account.

(1) Check One of the following Statements::

I am not currently participating in the Direct Deposit Program. OR I am currently participating in the Direct Deposit Program.

ADD - Deposit my payment to the account shown. CHANGE – Change financial institutions and/or account number.

(2) Installation EROC

Name or (Company as shown on invoice):

(3) Address:

(4) City: State: Zip:

(5) Mailing Address (if different):

(6) Daytime Phone: ( ) (7) Contract # (Optional):

If more than one contract, please list on a separate sheet.

Please ask your Financial Institution for your Depositor Account Number and Routing Number (Indicate which type account to credit)

Type of Depos Please check itor Account a box.

Checking (8) Saving (9)

Depositor Account Number (10)

Name of Financial Institution:

(11) Address:

(12) City:

(13)

State: Zip:

Routing Number:

(14) Depositor Account Title:

(15)

SIGNATURE:_(17) DATE:_(18) June 6, 2013

Mail To: USACE Finance Center, ATTN: EFT/DISB, 5722 Integrity Drive, Millington, TN 38054-5005

FORM: UFC-DISB-4

Tax ID Number (TIN) for Business:

(16)