Service Request for Financial Institution Audit or Risk Assessment

Service Request for Financial Institution Audit or Risk Assessment
Financial Institution Name
Routing Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
What prompted you to contact us about our services? (Choose one)

EmailPostcard/letter/direct mailConference or other eventReferred by my financial institutionPrior use of audit servicesEPCOR WebsiteOther
Please answer the following questions to determine your pricing:
What Services are you interested in?

ACH AuditACH Risk AssessmentRDC AuditRDC Risk AssessmentWire Transfer AuditWire Transfer Risk AssessmentRTP Audit
ACH Services
Do you have internal Origination, (i.e. loan payments, external ACH transfers)?

YesNo
How many Originators does your FI provide services to?
How many Third-Party Senders does your FI provide services to?
Please select the types of SEC Codes that your institution originates on behalf of Originators and/or Third-Party Senders as well as on behalf of your institution's internal processing:

PPD CreditsPPD DebitsCCD CreditsCCD DebitsCTX CreditsCTX DebitsTELWEB DebitsWEB CreditsARCBOCPOPRCKIATSame Day ACH CreditsSame Day ACH Debits
RDC Services
How many Merchants use your RDC services?
Do you offer mobile RDC to consumers and non-consumers?
Wire Transfer Services
How many incoming wire transfers are processed per month?
How many domestic wire transfers originated per month?
How many total international wire transfers originated during the previous calendar year?
How many international wire transfers were consumer?
How many international wire transfers were non-consumer?
RTP Services
Is your FI a Receiving only, or both a Sending and Receiving Participant of RTP?

Receiving OnlySending and Receiving
How many Sending Participants do you have?
Is your FI a Funding or non-Funding Participant?

FundingNon-funding
When did your FI begin processing RTP Entries?

MonthDayYear
Date
What are your preferred timeframes for the Service to be performed?
(Please list 3 dates or timeframes that work best for you.)
Timeframe option 1
*Dates subject to availability
Timeframe option 2
*Dates subject to availability
Timeframe option 3
*Dates subject to availability
Would you prefer a Remote or On-Site Service?

RemoteOn-SiteNo Preference
Has EPCOR provided Audit Services to your FI within the past two years?

YesNo
Did your FI have any significant “Non-Compliant” findings on your most recent audit?

YesNo
Has your FI had any of the following changes since last audit?

Data processor change/ACH Software changeMerger/AcquisitionCritical staff turnoverReport of Possible Rules Violation from NACHA
Comments
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Service Request for Financial Institution Audit or Risk Assessment

ACH Services

RDC Services

Wire Transfer Services

RTP Services