The University of Tennessee Is Pleased to Be Able to Offer Your Company Payment by ACH/Direct

The University of Tennessee is pleased to be able to offer your company payment by ACH/Direct Deposit. Your invoice payments will be automatically deposited into your company bank account. Every time a payment is made, your company contact will receive an email notification listing the invoice and credit memo numbers being paid along with the amount of the payment. Please complete the following information and return to the address at the bottom of the page.

Vendor Name ______UT Vendor Number ______

(FOR UT USE ONLY)

Vendor Contact ______Contact Email ______

Contact Phone # ______

Bank Name ______City, State______

Bank Account # ______Account Type: _____ Checking _____Savings

Bank Routing # (9 Digits)______

Account Name ______

I certify that the information above is true and correct and hereby authorize The University of Tennessee to automatically deposit payment for invoices into our account at the financial institution indicated. I also authorize withdrawal transactions from the account, limited to the amount of the original deposit, in the event of an overpayment or erroneous deposit. This authorization will remain in effect until The University of Tennessee has received, in writing, our cancellation notification. The notification should be sent to:

The University of Tennessee

Treasurer’s Office

ATTN: Accounts Payable Director

301 Andy Holt Tower

Knoxville, TN 37996-0100

______

Signature of Authorized Vendor Employee Date

Printed Name and Title______