Nyack, NY · Rockland County
ACH Vendor Payment Authorization Form
Vendors use this form to authorize the Village of Nyack to deposit payments electronically into a designated bank account.
What this form is
The form authorizes the Village of Nyack to transmit payment data electronically to a vendor’s financial institution. Vendors provide their contact and federal ID information, bank details, and an authorized signature, and agree to report banking changes in writing. The form states that recipients will receive a verification email after it is processed.
Who needs it
Vendors who want the Village of Nyack to deposit payments electronically into their designated bank account need to 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 without a notary; it identifies no notarized or sworn attachment or related step, so the signer simply signs the authorization.
How to submit this form
- 1
Download the Form
Download the ACH Vendor Payment Authorization Form.
- 2
Complete Vendor Details
Enter the vendor’s contact information and federal ID number.
- 3
Provide Bank Information
Enter the financial institution, routing number, account information, and account type.
- 4
Sign and Submit
Sign the authorization and submit it to the city department named on the form.
Frequently asked questions
- What does the ACH Vendor Payment Authorization Form do?
- It authorizes the Village of Nyack to electronically deposit payments to the bank account designated by the vendor.
- What information does the form ask for?
- It asks for vendor contact and federal ID information, financial institution and account details, account type, and an authorized signature.
- Do I need a notary for the ACH Vendor Payment Authorization Form?
- No. This form is signed without a notary, and it identifies no notarized or sworn attachment or related step.
- How do I submit the ACH Vendor Payment Authorization Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This ACH Vendor Payment Authorization Form doesn’t need a notary — but if you have another Nyack form that does, a commissioned online notary can help.