I certify I am responsible for notifying any changes to the information provided above to Carroll County Government. I agree to immediately return any erroneous payments that may occur as a result of payment via ACH. I certify the information provided on this form is true and correct, and that I, as an authorized representative for the above named company, authorize Carroll County Government to electronically deposit payments into the designated bank account. This authority remains in full force until written notice of change or cancellation is received by Carroll County Government. Carroll County Government reserves the right to cancel or suspend this authorization at any time.