Navigating through the process of setting up preauthorized payments in Tennessee has been made simpler with the implementation of the FA-0954 form. This crucial document bridges the communication between individuals or businesses and the State of Tennessee's Benefits Accounting, a department under the umbrella of Finance and Administration. With a focus on seamless transactions, the form allows for direct debit and credit entries to either checking or savings accounts, ensuring that payments or refunds are efficiently managed. Located in the heart of Nashville, the office facilitates these transactions with a layer of authority that requires prior consent from account holders. The form mandates essential details such as the agency's name, Employer Identification Number (EIN), and comprehensive bank account information, promising a secure and straightforward approach to automatic financial dealings. Signatories are reassured with the provision that this agreement stands until explicit termination notices are communicated, offering a blend of flexibility and control. By requiring a voided check, the process also adds an extra layer of verification, reinforcing the security and accuracy of the transactions intended. Overall, the FA-0954 represents a foundational structure in the administrative backbone of Tennessee's financial management, ensuring meticulous handling of automated payments and fostering trust between the state and its residents or business entities.
Question | Answer |
---|---|
Form Name | Form Fa 0954 |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | 0954 state of tennessee benefits administration form fa 0954 |
STATE OF TENNESSEE
BENEFITS ACCOUNTING
DEPARTMENT OF FINANCE AND ADMINISTRATION
20TH FLOOR, WILLIAM R. SNODGRASS TENNESSEE TOWER
312 ROSA L. PARKS AVENUE
NASHVILLE, TENNESSEE 37243
FAX (615)
AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENT (ACH)
Agency Name:
Employer Identification Number (EIN):
I (we) hereby authorize the State of Tennessee, hereinafter called the State, to initiate debit and credit entries to my (our) Checking Savings Account (select one) indicated below, and the deposi- tory named below, hereinafter called the Depository, to debit the same to such account.
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This authority is to remain in full force and effect until the State and Depository have received written notification from me (or either of us) of its termination in such time and in such manner as to afford the State and Depository a reasonable opportunity to act on it.
Name (s):
Please print
Date:
Signed:Signed:
Business Unit:
Please attach a voided check.