AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS (ACH CREDITS)
Company Company
Name North Central Texas College ID Number 75-1050382
I (we) hereby authorize North Central Texas College, hereinafter called COMPANY, to initiate credit entries and to initiate if necessary, debit
entries and adjustments for any credit entries in error to my (our)
Checking Account/ Savings Account (select one) indicated below at the
depository financial institution named below, hereafter called DEPOSITORY, and to credit the same to such account. I (we) acknowledge that
the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.
Depository
Name
___________________________________________Branch ______________________
City ______________________________________State _________Zip __________________
Routing Account
Number __________________________________ Number ____________________________
This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of
us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to
act on it.
Name(s)_________________________________ID Number ___________________________
(Please print)
Da
te ___________________________________Signature _____________________________________________
NOTE: ALL WRITTEN CREDIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MAY REVOKE
THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE
AUTHORIZATION.
NOTE: IN THE EVENT AN ERROR OCCURS ON THE PART OF THE COMPANY OR THE RECEIVER, IT MAY
TAKE UP TO SEVEN (7) DAYS TO RESOLVE.
HERRING BANK
AMARILLO
TX 79109
111302846
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