Common Contracts

1 similar Authorization Agreement for Electronic Funds Transfer contracts

AUTHORIZATION AGREEMENT FOR ELECTRONIC FUNDS TRANSFER (SCO EFT-1)
Authorization Agreement for Electronic Funds Transfer • January 4th, 2007

Complete Section I Below: Please Check Appropriate Boxes New ACH RegistrationChange EFT Remittance Method Change Holder Contact Information HOLDER INFORMATION FEDERAL EMPLOYER ID# (FEIN): - NAME ADDRESS CITY STATE ZIP UNCLAIMED PROPERTY HOLDER TYPE CODE PHONE ( _ _ _ ) _ _ _ - _ _ _ _ EXT CONTACT INFORMATION (for EFT Registration) NAME EMAIL PHONE ( _ _ _ ) _ _ _ - _ _ _ _ EXT FAX ( _ _ _ ) _ _ _ - _ _ _ _ Complete Section II, III or IV Below: SECTION II ACH DEBIT I have verified our company’s Financial Institution can originate an ACH Debit transaction in the required record field. SIGNATURE: TITLE DATE SECTION III ACH CREDIT I have verified our company’s Financial Institution can originate an ACH Credit transaction in the required record field. SIGNATURE: TITLE DATE SECTION IV INTERNATIONAL FUNDS TRANSFER SIGNATURE TITLE DATE

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