Bank Detail Change Request
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Investor's Name
*
First Name
Last Name
Name on Bank Account (if different)
First Name
Last Name
Company Name (If Applicable)
Financial Institution
*
Routing Number
*
Account Number
*
Deposit funds to:
*
Checking
Savings
Change Effective Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Wire Details (If Applicable)
Bank Name:
Bank Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
ABA Number:
Account Name:
Account Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account Number:
Further Credit To (include identifying (account) number):
I acknowledge I am changing my bank account ACH payment information. I understand it may take Trophy Point one full quarter to process the change, depending on when I submit my request.
*
I Acknowledge
Signature
*
Submit
Should be Empty: