ACH File Transmittal
Complete static information, print, make copies as needed.
A Transmittal should be faxed for each file uploaded.
To:
Fax To:
From:
Phone:
Fax:
Net Zero File Settlement Entry Information, if applicable.
ABA
Checking Account
Amount
Select:
Debit
Credit
File Name
Batch Count
Total Items
Debit Total
Credit Total
Effective Date
Signed by:
____________________________________________________________
Date:
______________________________
Last Form Revision: 03/29/2004
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