Who uses the ACH/EFT Authorization Form?

Vendors use it to set up or change banking information for electronic payments from the City of Gardena for goods or services.

What should I include with the form?

Submit a voided check or bank documentation with the form. The form says the routing number must be the nine-digit number from a check, not a deposit slip.

Do I need a notary for the ACH/EFT Authorization Form?

No. The form is signed and dated without a notary; include a voided check or bank documentation, and no notarized or sworn attachment is stated.

How do I submit the ACH/EFT Authorization Form?

Send the completed form and a voided check or bank documentation to the City of Gardena at 1700 West 162nd Street, Gardena, California 90247-3732.

Gardena, CA · Los Angeles County

No notary required

ACH/EFT Authorization Form

Vendors use this form to authorize the City of Gardena to send electronic payments to a designated bank account for goods or services.

What this form is

This form lets a vendor authorize the City of Gardena to make ACH/EFT payments to the vendor’s bank account for goods or services. Vendors provide contact and banking information, choose whether they are setting up or changing a vendor account, and authorize the city to correct erroneous credits. The form requests an email for remittance advice and requires a voided check or bank documentation.

Who needs it

A vendor setting up or changing payment banking information with the City of Gardena should complete this form.

How to submit it

Submit the completed form with a voided check or bank documentation to the City of Gardena at the address printed on the form: 1700 West 162nd Street, Gardena, California 90247-3732.

About notarization

This form is signed and dated without a notary; include a voided check or bank documentation, with no notarized or sworn attachment stated.

How to submit this form

1
Download the Form
Download the ACH/EFT Authorization Form.
2
Complete the Vendor Information
Choose new setup or change, then provide vendor contact details and an email for remittance advice.
3
Enter Banking Information
Select checking or savings and provide the bank, account name, routing number, and account number.
4
Gather Supporting Documentation
Include a voided check or bank documentation with the completed form.
5
Submit to the City
Send the form and supporting documentation to the City of Gardena address printed on the form.

Frequently asked questions

Who uses the ACH/EFT Authorization Form?: Vendors use it to set up or change banking information for electronic payments from the City of Gardena for goods or services.
What should I include with the form?: Submit a voided check or bank documentation with the form. The form says the routing number must be the nine-digit number from a check, not a deposit slip.
Do I need a notary for the ACH/EFT Authorization Form?: No. The form is signed and dated without a notary; include a voided check or bank documentation, and no notarized or sworn attachment is stated.
How do I submit the ACH/EFT Authorization Form?: Send the completed form and a voided check or bank documentation to the City of Gardena at 1700 West 162nd Street, Gardena, California 90247-3732.

Need something notarized?

This ACH/EFT Authorization Form doesn’t need a notary — but if you have another Gardena form that does, a commissioned online notary can help.