Authorization for Direct Deposit (ACH CREDIT)

I (we) hereby authorize ______________________, hereinafter called “COMPANY”, to initiate electronic credit entries to my (our) account indicated below and the financial institution named below, hereinafter called “FINANCIAL INSTITUTION”. I (we) acknowledge that ACH transactions I (we) authorize must comply with all applicable law. In the event of an erroneous or duplicate entry, I hereby authorize “COMPANY” to debit my account indicated below to correct any error made.

ACH Vendor Direct Deposit

Company Name*
Financial Institution*
ACH Routing Number*

Double check this because some banks have different ACH routing numbers.
Account Number*
Type of Account*
- Checking
- Savings
Electronic Signature*

By typing your name here, you are electronically signing this document.
Date*
Month
Day
Year