Coral Gables Community Foundation | Grantee ACH Deposit Authorization Form

Grantee ACH Deposit Authorization

Name, Email and phone of person who might handle accounts receivable at your organization.

Full Name(Required)

First Middle Last Suffix

TItle

If applicable

Phone(Required)

Needed only in case there are questions about this agreement or a transaction

Email Address(Required)

Email Address Confirm Email Address

EIN / TAX ID Number(Required)

(SSN if individual)

Your Address(Required)

Street Address Address Line 2 City State ZIP Code

Grantee BANK NAME

Grantee BANK ABA ROUTING NUMBER

Grantee ACCOUNT NAME

The name your bank will recognize for your organization

Grantee BANK ACCOUNT NUMBER

Your account number with your bank

Type your name as your signature(Required)

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This field is for validation purposes and should be left unchanged.