Laserfiche WebLink
OFFICIAL <br /> PAYMENTS <br /> A T I E R C O M P A N Y <br /> 2333 San Ramon Valley Blvd., Suite 450, San Ramon, California 94583 <br /> [p] 925.855.5000 www.officialpayments.com <br /> CREDIT CARD <br /> ELECTRONIC DEPOSIT INSTRUCTIONS <br /> The undersigned hereby authorizes Official Payments Corporation (OPC) and its Suppliers to perform <br /> Automated Clearing House Credits "ACH Credits for settlements and Debits "ACH Debits for credit <br /> card reversals and chargebacks, in accordance with the Electronic Payment Processing Agreement, to the <br /> following bank account: <br /> Client /Entity Name and Address: <br /> TUKWILA MUNICIPAL COURT Federal Tax ID 91- 6001519 <br /> 6200 SOUTHCENTER BLVD Phone Number: 206 433 -1840 <br /> TUKWILA, WA 98188 FAX Number: 206 433 -7160 <br /> Annual Gross Collections: $325,000 <br /> For Account Chanqes Onlv: Please attach a"copy of a voided check or a bank letter for the <br /> new account to make the changes in timel manner. <br /> 1 <br /> Effective date of bank changes: Julv 1 007 <br /> Banking Information For ACH Credits (Settlements) and Debits (Chargebacks Reversals): <br /> IMPORTANT: Please fill out the following information accurately to ensure timely settlement and to avoid <br /> deposit returns and rejects. Please attach a copy of a voided check. <br /> Bank Account Number: 234 7115061 <br /> Bank ABA /Routing Number: 125008547 <br /> Account Name: TUKWILA MUNICIPAL COURT <br /> Bank Name: WELLS FARGO BANK, N.A. <br /> Bank Address: 343 ANDOVER PARK E <br /> TUKWILA WA 98188 <br /> Bank Phone Number: 206- 394 -5333 <br /> Client Authorization: <br /> Print Name: LATRICIA KINLOW <br /> Signature: <br /> Title: COURT ADMINISTRATOR <br /> Date: June 25, 2007 <br /> Rev. August 2006 <br />