Unauthorized ACH Return Form at a glance
What it is: The Unauthorized ACH Return Form is the Corporate Request for Return of an Unauthorized ACH Transaction (if not ACH, please call the number on the back of your card).
Where and when to file: Small Business Clients: Email this form to ACHforms@bofa.com.
A filled-in Unauthorized ACH Return Form example: a company disputes one debit
How to fill out Unauthorized ACH Return Form, box by box
Name, account and routing
Fill in Name, Account # and Routing Transit.
Alternate Account #: If the original account has been closed please provide an open account number.
Who requests it and signs
Fill in Requested By, Email Address, Today's Date, Contact Phone # and Fax #.
Requests must be signed by an authorized signer on your account. Sign on the line marked Signature.
The signer of this request asserts that this written statement of Unauthorized ACH Debit/Credit is true and correct and further asserts that the signer is an authorized signer on the account or has corporate authority to act on the account in order to file this request.
Unauthorized Reason
Populate the Unauthorized Reason column with the number that matches your claim scenario. The Unauthorized Reason field MUST be completed. If your request does not meet one of the five definitions of unauthorized transactions listed under Unauthorized Reason or did not post to your account one business day prior to today please contact 888.287.4637.
A debit entry was not authorized by the Receiver if: (1) Your company did not authorize the Originator to debit/credit your account. The authorization requirements (Receiver Authorization and Agreement) have not been met. (2) The debit entry was initiated in an amount greater than that authorized by the Receiver; or (3) The debit entry was initiated for settlement earlier than authorized by the Receiver.
(4) My account / identity has been compromised and / or checks were stolen. If you have been a victim of fraud and you suspect someone please provide their name here:
(5) Other (Must specify):
An unauthorized debit entry does not include a debit entry initiated with fraudulent intent by the Receiver or any person acting in concert with the Receiver.
Transaction
For each transaction, enter the Originating Company Name, Originating Company ID, Transaction Amount, Debit/Credit, Posting Date (MM/DD/YY) and Unauthorized Reason.
BANK USE ONLY
BANK USE ONLY: Verification, Phone # and Initial.
More rules for Unauthorized ACH Return Form
Please ensure that all fields are completed and formatted properly, such as date fields in a MM/DD/YY format. Any missing information may cause delays in the resolution of your claim.
Common questions about Unauthorized ACH Return Form
Is there a deadline?
Unauthorized ACH Return Requests must be submitted no later than the business day following posting so that it is received and processed by 7:00 p.m. Eastern Time.
Where do I file it?
Small Business Clients email this form to ACHforms@bofa.com, or fax it to Bank of America ACH Services 877.867.6823 by 7:00 p.m. Eastern.
Sources
[1] Unauthorized ACH Return Form, Bank of America (the Official source link on this page).