ACH Origination Annual Security Review Form

When I receive a New ACH Recipient or a Change of Account for an existing ACH Recipient:

I (originator) agree that I have safeguarded my sensitive information by utilizing the following controls:

By signing this acknowledgement, you agree that you are an authorized ACH Representative designated in the ACH Origination Agreement or an Account Owner on the accounts authorized to use the services contracted above and have implemented the controls above and understand that these are your (originator’s) responsibility to monitor accordingly to safeguard personal recipient information.