Direct Deposit Request Form

Direct Deposit Request Form
This form is for notifying the Federation of your interest in our Direct Deposit program. Once you submit this form, our Executive Director, Jack Riffle will contact you to provide more information on how to securely submit your information via a link sent to your email address.

Please note: no one from the Federation will request your banking information, you will receive instead a link in your email to securely submit your information. Do not provide any sensitive information over the phone to anyone.
Name*

First NameLast Name
Business Name*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Should be Empty: