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The NY DMV FM-139 form, titled ACH Liaison Designation, is a legal document used by DMV escrow account holders to formally appoint an individual as an electronic payment liaison. This designation authorizes the named liaison to manage Automated Clearing House (ACH) transactions, which facilitate the electronic transfer of funds from a bank account into a DMV escrow account via the DMV website.
The form requires the submission of specific identification details for the liaison, including their full name, a Liaison ID number sourced from a driver license or non-driver ID card, the issuing state of that identification, and a professional email address. To be valid, the account holder must provide a formal signature, printed name, title, and the date of authorization, thereby certifying that the designated person is permitted to oversee financial activities for the specific FINS account number provided.
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