action is a change or a delete, please provide:
ACH Payer Unit Number:
action is an add, change, or delete, please provide the following
provide applicable importer number or 3 digit filer code of ACH applicant.
3 digit filer code:
must be a National Automated Clearinghouse Association (NACHA) participant
Bank Transit - Routing Number:
Bank - Account Number:
ensure the accuracy of the account information, it is requested that
a specification sheet (obtained from your bank) be completed and accompany
this application. The ACH payer will be held responsible for defaults
which result from incomplete or erroneous account information when
the specification sheet is not submitted and certified by bank personnel.
Please verify that the bank transit routing and account numbers on
the ACH application and specification sheet match before forwarding
to the National Finance Center.
of Customs Broker/Filer:
digit filer code:
Customs ABI Client Representative of Customs Broker/Filer:
of Authorizing Company Official:
of Authorizing Company Official (please type or print)
application should be printed and faxed or mailed to the ACH coordinator
U.S. Customs Service
National Finance Center
6026 Lakeside Blvd.
Indianapolis, IN 46278