Direct Deposit Authorization (ACH)
One-Time Transfer
Name
*
First Name
Last Name
Email
*
example@example.com
Your Address (needed for tax letter)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name(s) on Bank Account (business name if used)
*
Routing Number
*
must be 9 numbers - no spaces
Account Number
*
must be 9-12 numbers - no spaces
Re-Enter Account Number
*
must be 9-12 numbers - no spaces
Account Numbers Must Match
Bank Name
*
Type of Bank Account
*
Personal Checking
Personal Savings
Business Checking
Business Savings
Other
Amount
*
Date to Draft
*
/
Month
/
Day
Year
Date
Recurring? Check if Yes
Recurring frequency:
Leave blank for one time donations
Frequency
Please Select
Monthly
Every 2 Months
Quarterly
Every 6 Months
Annually
Recurring donations will process on the date specified and the same date thereafter, according to frequency
Signature
*
Submit
Should be Empty: