FMR Banking Information

Bank Info for Donations
IF YOU ARE UNDER 18, A PARENT OR GUARDIAN WILL NEED TO FILL OUT THIS FORM

Please provide the following information for donation(s) and payment(s) in order for us to transfer funds to your banking institution. Please allow 48 to 72 hours for the funds to appear in your account once we initiate the transfer. You will receive an itemized invoice for each transferred amount via email.
Racer's Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Are you registered as a business*

No - Individual with a social security numberYes - Incorporated (LLC, S Corp, etc.) with an EIN tax numberYes - Business (DBA or Sole Proprietor) with an EIN tax number
Company Name (if a business)
EIN Tax Number (If a business)
Address (Company address if a business)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Photo of the front side of your driver's license*

Cancelof
Photo of the back side of your driver's license*

Cancelof
Name on the banking account*

First NameLast Name
Name of your bank*
Routing Number*
Account Number*
Wire Routing Number
If you have any questions, please email info@fundmyrace.org
Signature

Clear
Date: today's date

MonthDayYear
Date
Should be Empty:

Bank Info for Donations