FedACH Participation Agreement
Contents
1. Federal Reserve Bank INTERNAL FR FedACH Participation Agreement FRBservices org Part 6A Service Request Form for FedGlobal ACH Payments Section A FedGlobal Service Request Form This form is used to sign up for or make service changes to FedGlobal ACH Payments which enables a Participating Institution to originate payments to receivers in certain foreign countries via FedACH This Service Request Form for FedGlobal ACH Payments does not include the F3X Service a messaging service for select foreign currencies To sign up for the F3X service complete the F3X Service Request form When you submit this section of the Participation Agreement the submitted section supersedes any previous versions of the same section Requested Effective Date ACH Process Date Must be received by the Reserve Bank at least ten business days prior to the requested effective date Actual effective date may vary from requested date 1 General Information Participating Institution Nine Digit Routing Number Contact Name for FedGlobal Migale mial Last Service Contact Phone Number Phone Extension Contact Email Address 2 List Other Institutions That Will Be Originating FedGlobal ACH Payments The individual signing for the Participating Financial Institution in the Authorization section below must be an authorized ACH signer on the Official Authorization List of the institution s listed be2. low Otherwise a separate FedGlobal Request Form must be completed by each Institution Institution Name Routing Transit Number Last Updated October 2015 Page 1 of 2 Federal Reserve Bank INTERNAL FR FedACH Participation Agreement Part 6A Service Request Form for FedGlobal ACH Payments Section A FedGlobal Service Request Form 3 Countries Regions Participating Institution s will originate Individual Countries Regions items to O Canada L Europe Check appropriate box or boxes O Mexico 0 Other Latin America C Panama Check country list product offerings and service availability at www frbservices org 4 ACH Origination Software List the name of the Supplier Vendor and the ACH Application Software your institution will use for cross border payment origination Software Supplier Vendor Application Name 5 Authorization You have read the FedGlobal Service Manual and agree to test international transactions with FedACH prior to service start up You agree to the provisions of the Reserve Bank s Operating Circular No 4 entitled Automated Clearing House Items and its appendices as amended from time to time and to the applicable ACH rules The Reserve Bank may publish a list of all Participating Institutions that have signed up for FedGlobal ACH Check the box below if your institution does not want to be listed as a FedGlobal ODFI L Do not include my in
3. stitution in the published list of FedGlobal ODFIs Signature Authorized ACH signer on Official Authorization List Printed Name Phone Number Completed agreements can be faxed to 877 281 3647 or e mailed to ccc bankservices kc frb org Last Updated October 2015 Page 2 of 2
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