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  1. Click ‘Get Form’ to open the fillable ACH Vendor/Miscellaneous Payment Enrollment Form in the editor.
  2. Begin with the Agency Information Section. Enter the name and address of the Federal program agency, along with the agency identifier and location code. Ensure you provide a contact person's name and telephone number, and check the appropriate ACH format box.
  3. Move to the Payee/Company Information Section. Fill in the payee's name, address, Social Security or Taxpayer ID number, and contact details. Verify that your financial institution has correctly entered your depositor account title and number.
  4. In the Financial Institution Information Section, input your financial institution's name and address. Include the ACH coordinator's name and phone number, along with the nine-digit routing transit number. Confirm that you check the type of account box and provide a signature from an authorized official.
  5. Review all sections for accuracy before saving your completed form. Make three copies as instructed: one for the agency, one for the payee/company, and one for your financial institution.

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ACH Vendor/Miscellaneous Payment Enrollment

This form is used for Automated Clearing House (ACH) payments with an addendum record that contains payment-related information processed through the DirectRead more

Learn more
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 VendorRead more

Learn more
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