Greenview, IL · Menard County
ACH Authorization Form
This form lets a person authorize a company to make entries to a checking or savings account and submit adjustments for transactions credited or debited in error.
What this form is
The ACH Authorization Form records permission for a company to initiate entries to a checking or savings account and, if necessary, adjust transactions credited or debited in error. The form asks for financial institution and account details, an amount or maximum amount, and the signer’s name, address, signature, and date. It does not state when the city requires the form or where to submit it.
Who needs it
A person who wants to authorize a company to initiate entries to a checking or savings account can complete this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; the form does not mention any notarized or sworn attachment.
How to submit this form
- 1
Download The Form
Download the ACH Authorization Form PDF.
- 2
Complete The Form
Enter the financial institution and account details, an amount or maximum amount, and your printed name and address.
- 3
Sign And Date
Sign and date the authorization.
- 4
Submit To The City
Submit the form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What does the ACH Authorization Form authorize?
- It authorizes a company to initiate entries to a checking or savings account and, if necessary, adjust transactions credited or debited in error.
- What information does the form ask for?
- It asks for the financial institution’s name and address, an amount or maximum amount, routing and account numbers, and the signer’s printed name, address, signature, and date.
- Do I need a notary for the ACH Authorization Form?
- No. The document is signed and dated without a notary, and it does not mention any notarized or sworn attachment.
- How do I submit the ACH Authorization Form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.