Fillable 2293 - AP direct deposit authorization

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2293 - AP direct deposit authorization

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The 2293 - AP direct deposit authorization form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for Terrapin Networks

BROWSE TERRAPIN NETWORKS (MI) FORMS

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ACCOUNTSPAYABLE

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AUTHORIZATIONAGREEMENTFORDIRECTDEPOSITS(ACHCREDIT)

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IherebyauthorizetheCityofManisteetoinitiatecreditentriesforthedirectdepositofAccountsPayable

invoice payments to the account indicated below at the depository financial institution named below.

Please attach a copy of a voided check for this account to ensure the accuracy of the routing and

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accountnumbers.

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BANK

NAMEBRANCH

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CITYSTATE ZIP

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ROUTING#ACCOUNT#

CheckingorSavings  

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This authorization is to remain in full force and effect until the City of Manistee has received written

notificationfrommeofitsterminationinsuchtimeandinsuchmannerastoaffordtheCityofManisteea

reasonableopportunitytoactonit.Itistheresponsibilityof

thecustomertoensurethatanychangesin

theiraccountinformationarecommunicatedtimelytotheCityofManistee.

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CompanyNamePhone#

(PleasePrint)

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SignatureDate

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Name&Title

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Address

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

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e‐mailaddressforremittancestubs

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ForInternalUseOnly

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Account#DateProcessed

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