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ACH AUTHORIZATION AGREEMENT FOR AUTOMATIC DIRECT DEPOSIT ...

Page 1 of 24/17/2018 ACH AUTHORIZATION AGREEMENTFOR AUTOMATIC DIRECT DEPOSIT OF MIAMI-DADE COUNTY WARRANTSWe hereby authorize the Finance Department to initiate credit entries and, if necessary, a debit entry in order to reverse a credit entry made inerror in accordance with NACHA rules. Original form must be received before we can process your request for ACH deposits . Please refer to page 2 for instructions. Processing of the form is approximately 15 days from receipt of completed original form . This authority is to remain in effect until revoked in writing and received by the Finance Department. Account changes must be reported at a minimum fifteen (15) days prior to actual 1 (TO BE COMPLETED BY VENDOR) - ALL FIELDS ARE REQUIREDTRANSACTION TYPE:NewChange TerminateFEDERAL IDENTIFICATION NUMBER(AS PER CURRENT W-9)(FOR INTERNAL USE ONLY)VENDOR NAME :DBA (DOING BUSINESS AS) :TELEPHONE NUMBER :FISCAL OFFICER NAME AND T

form is approximately 15 days from receipt of completed original form. This authority is to remain in effect until revoked in writing and ; received by the Finance Department.

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