In the bustling economic landscape of Michigan, the introduction of the Michigan Department of Treasury 3636A form heralds a significant shift towards modernizing financial transactions between the state and its vendors. Crafted under the Public Act 94 of 1979, this form empowers vendors with a choice to adopt a more efficient, secure method of receiving payments through Electronic Funds Transfer (EFT), a direct deposit system. Its utilization spans various scenarios, including new authorizations where vendors are required to input their banking details online, changes to their existing account information, and the option for cancellation or revocation of previous authorizations. The form is meticulously designed to streamline the payment process, offering conveniences such as rapid payment receipts and error corrections, all while reducing paper-based transactions. Moreover, it comes with a layer of security and compliance, mandating vendors to align with both the National Automated Clearing House Association Rules and Regulations and the State's own electronic funds transfer guidelines. This pivotal move not only signifies the State’s commitment to leveraging technology for operational efficiency but also places an onus on vendors to maintain accurate and up-to-date financial information, ensuring a seamless transition and minimizing the risk of payment delays or losses due to data inaccuracies. With its voluntary filing status, the 3636A form represents a bridge between traditional banking and the digital age, underscoring Michigan's broader efforts to modernize its financial infrastructure to the benefit of all stakeholders involved.
| Question | Answer |
|---|---|
| Form Name | 3636A Form Michigan |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | EFT, Revocation, Michigan, CPE |
Michigan Department of Treasury 3636A (Rev.
STATE OF MICHIGAN
Electronic Funds Transfer (Direct Deposit)
Authorization for Vendor Payments
Issued under P.A. 94 of 1979. Filing is voluntary.
Type of authorization (select one only)
NEW: Enter all banking information on the C&PE Web site before completing and submitting this form.
CHANGE: Enter all bank related changes on the C&PE Web site first. Then complete this form by entering changes to the financial institution, account number, or type of account; and submit the completed form. Do not close your old bank account until electronic payments are received in your new account.
CANCELLATION (Revocation): You may cancel (revoke) your prior Authorization by either inactivating your EFT authorization on the C&PE Web site or by checking this box and completing and submitting this form.
Mail completed form to: State of Michigan, Department of Management & Budget, Office of Financial Management, P.O. Box 30026, Lansing, MI
Please print or type. |
The number below is: |
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Individual Taxpayer ID No. (ITIN) |
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PAYEE INFORMATION |
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Social Security No. (SSN) |
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Federal Employer ID No. (FEIN) |
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1. |
Payee Name |
2. |
SSN, FEIN or ITIN |
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3. |
Mailing Address (Street or RR#) |
4. |
City, State, ZIP Code |
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5. |
Name and Title of Contact Person |
6. |
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7. Daytime Telephone Number |
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8. |
Financial Institution Name |
9. |
Routing Transit Number |
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10. Financial Institution Telephone Number |
11. Account Holder's Name(s) |
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12. Account Number for Deposit of Electronic Funds Transfer |
13. Account Type (Select one only) |
14. Account Indicator |
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Checking |
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Savings |
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Consumer |
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Commercial |
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I authorize the State of Michigan to deposit payments owed to me by the State, by electronic funds transfer into the designated financial institution and account number. I also authorize the State of Michigan to make corrections from this account in the event that a deposit from the State of Michigan is made in error. Further, I agree not to hold the State of Michigan responsible for any delay or loss of funds due to incorrect information I have supplied on this authorization form. I understand this authorization remains in effect until cancellation: (a) in writing by the Payee or Payee's Authorized Signatory, (b) by the State of Michigan, or (c) by accessing your State of Michigan vendor record on the C&PE Web site and cancelling electronically.
I consent to and agree to comply with the National Automated Clearing House Association Rules and Regulations and the State of Michigan's rules about electronic funds transfers as they exist on the date of my signature on this form or as subsequently adopted, amended or repealed. Michigan law governs electronic funds transactions authorized by this agreement in all respects except as otherwise superseded by federal law.
If more than one signature is required to authorize withdrawal of funds, all must sign this form. Attach a page with additional signatures, if necessary.
15. |
Print or Type Name of Payee or Payee's Authorized Signatory |
16. |
Title of Authorized Signatory |
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17. |
Signature of Payee or Payee's Authorized Signatory |
18. |
Date |
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19. |
Signature of Secondary Signatory(s) |
20. |
Date |
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