ACH Direct Deposit – Fiscal Sponsorships

ACH Direct Deposit

By completing this form, you authorize the Christian Ministry Alliance (Alliance) to initiate automatic deposits to my account at the financial institution named below. You also authorize the Alliance to make withdrawals from this account in the event that a credit entry is made in error. Further, you agree not to hold the Alliance responsible for any delay or loss of funds due to incorrect or incomplete information supplied or by my financial institution or due to an error on the part of your financial institution in depositing funds . This agreement will remain in effect until the Alliance receives a written notice of cancellation from you, or until you submit a new direct deposit form to the Payroll Department.

Personal Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Account Information

Name of Institution *

Account Type *

Routing Number *

Account Number *

Anticipated Monthly Salary/Disbursement *

If your fund balance is less than your anticipated disbursement, we will transfer your current fund balance in full.

Signature *

Clear Signature

Your signature legally allows the Christian Ministry Alliance to deposit funds in your specified account. Please sign in the box using finger on a touch screen or mouse on a desktop.

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