Authorization Agreement For Automated Clearing House Transactions (ACH Debits)

Customer Information

Above named Customer hereby authorizes Sussex County to initiate Automated Clearing House electronic funds transfer (EFT) debit entries to Customer's account, as indicated below.

Banking Information

* Provide the 9 digit bank routing number from a check. The routing number from a deposit slip is invalid.

 

This authority is to remain in full force and effect until Sussex County has received notification from an authorized person for this account of its termination in such time and manner as to afford Sussex County and your Bank a reasonable opportunity to act on it.

Customer Authorization

THE ENROLLMENT FORM MUST BE RECEIVED AT LEAST 15 DAYS PRIOR TO PAYMENT DUE DATE.