Ach Vendor Payment Form PDF Details

The process for enabling Automated Clearing House (ACH) payments, essential for vendors and miscellaneous payees aiming to streamline transaction processes with federal agencies, relies heavily on the precise completion of the ACH Vendor/Miscellaneous Payment Enrollment Form. Designed to facilitate the transmission of payment-related information through the Vendor Express Program, this form stands as a vital component for those seeking efficient, electronic fund transfers. It invites particular attention to presenting critical data to financial institutions, thereby ensuring the smooth processing of these electronic payments. In compliance with the Privacy Act of 1974, the form comprehensively gathers requisite details under legal mandates, including information from federal agencies, the payees or companies, and their respective financial institutions. Through sections dedicated to agency information, payee or company details, and financial institution data, the form captures all necessary identifiers, contact details, and banking information to operationalize the ACH payments effectively. Additionally, adherence to the instructions and the provision of accurate data can significantly influence the receipt of payments, highlighting the form's role in mitigating delays or complications in the ACH Payment System. Moreover, the document provides a structured pathway for entities to align with federal stipulations for electronic payments, underscoring the importance of comprehending and correctly filling out the form to ensure uninterrupted and expedited payment processes.

QuestionAnswer
Form NameAch Vendor Payment Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesowcp ach form, payment information form ach vendor payment system dol sf form 3881, 3881, dol ach form

Form Preview Example

OMB No. 1510-0056

ACH VENDOR/MISCELLANEOUS PAYMENT

ENROLLMENT FORM

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains payment-related information processed through the Vendor Express Program. Recipients of these payments should bring this information to the attention of their financial institution when presenting this form for completion. See reverse for additional instructions.

PRIVACY ACT STATEMENT

The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). All information collected on this form is required under the provisions of 31 U.S.C. 3322 and 31 CFR 210. This information will be used by the Treasury Department to transmit payment data, by electronic means to vendor's financial institution. Failure to provide the requested information may delay or prevent the receipt of payments through the Automated Clearing House Payment System.

AGENCY INFORMATION

FEDERAL PROGRAM AGENCY

AGENCY IDENTIFIER:

AGENCY LOCATION CODE (ALC):

ACH FORMAT:

 

 

 

 

 

 

CCD+

 

CTX

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS:

 

 

 

 

 

 

CONTACT PERSON NAME:

ADDITIONAL INFORMATION:

TELEPHONE NUMBER:

( )

PAYEE/COMPANY INFORMATION

NAME

ADDRESS

CONTACT PERSON NAME:

SSN NO. OR TAXPAYER ID NO.

TELEPHONE NUMBER:

( )

FINANCIAL INSTITUTION INFORMATION

NAME:

ADDRESS:

ACH COORDINATOR NAME:

TELEPHONE NUMBER:

( )

NINE-DIGIT ROUTING TRANSIT NUMBER:

DEPOSITOR ACCOUNT TITLE:

DEPOSITOR ACCOUNT NUMBER:

 

 

 

 

 

LOCKBOX NUMBER:

 

 

 

 

 

 

 

 

 

TYPE OF ACCOUNT:

 

 

 

 

 

 

 

 

CHECKING

 

SAVINGS

 

LOCKBOX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE AND TITLE OF AUTHORIZED OFFICIAL:

 

 

 

 

TELEPHONE NUMBER:

(Could be the same as ACH Coordinator)

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

AUTHORIZED FOR LOCAL REPRODUCTION

SF 3881 (Rev. 2/2003 )

 

Prescribed by Department of Treasury

 

31 U S C 3322; 31 CFR 210

Instructions for Completing SF 3881 Form

Make three copies of form after completing. Copy 1 is the Agency Copy; copy 2 is the Payee/ Company Copy; and copy 3 is the Financial Institution Copy.

1.Agency Information Section - Federal agency prints or types the name and address of the Federal program agency originating the vendor/miscellaneous payment, agency identifier, agency location code, contact person name and telephone number of the agency. Also, the appropriate box for ACH format is checked.

2.Payee/Company Information Section - Payee prints or types the name of the payee/company and address that will receive ACH vendor/miscellaneous payments, social security or taxpayer ID number, and contact person name and telephone number of the payee/company. Payee also verifies depositor account number, account title, and type of account entered by your financial institution in the Financial Institution Information Section.

3.Financial Institution Information Section - Financial institution prints or types the name and address of the payee/company's financial institution who will receive the ACH payment, ACH coordinator name and telephone number, nine-digit routing transit number, depositor (payee/ company) account title and account number. Also, the box for type of account is checked, and the signature, title, and telephone number of the appropriate financial institution official are included.

Burden Estimate Statement

The estimated average burden associated with this collection of information is 15 minutes per respondent or recordkeeper, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Financial Management Service, Facilities Management Division, Property and Supply Branch, Room B-101, 3700 East West Highway, Hyattsville, MD 20782 and the Office of Management and Budget, Paperwork Reduction Project (1510-0056), Washington, DC 20503.

How to Edit Ach Vendor Payment Form Online for Free

The Florida filling out procedure is easy. Our PDF tool enables you to work with any PDF document.

Step 1: Click on the "Get Form Here" button.

Step 2: Now you can enhance your Florida. You need to use the multifunctional toolbar to insert, remove, and adjust the content material of the document.

Fill out all of the following segments to complete the document:

Depositor empty fields to fill out

Note the essential particulars in ACH COORDINATOR NAME, NINEDIGIT ROUTING TRANSIT NUMBER, DEPOSITOR ACCOUNT TITLE, DEPOSITOR ACCOUNT NUMBER, TYPE OF ACCOUNT, TELEPHONE NUMBER, LOCKBOX NUMBER, TELEPHONE NUMBER, SF Rev Prescribed by Department, CHECKING, SAVINGS, LOCKBOX, SIGNATURE AND TITLE OF AUTHORIZED, and AUTHORIZED FOR LOCAL REPRODUCTION segment.

stage 2 to completing Depositor

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