1. Secure a separate, non-interest-bearing account at a financial institution of your choice. Bank ACH Representative: Date: (SIgnature).AHSC is the umbrella term for eviction prevention funding in Allegheny County. Tenants and landlords do not need to apply to individual programs. We will cover how to properly fill out an ACH form and how to submit the additional information required. This involves filling in the required information your name, bank account, authorization for the transfer of funds, etc. Receive your AblePay card in the mail and keep with insurance card. Payment Terms and Savings: Payment Terms, Bank ACH, Card. Board of Allegheny County. Complete and return to: ATTACH A VOIDED CHECK FOR.