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ACH Authorization Form

DIRECT DEPOSIT/ACH ELECTONIC FUNDS TRANSFER
AUTHORIZATION AGREEMENT

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I (we) hereby authorize Florida Youth Soccer Association, Inc. to initiate credit/deposit to my (our) account indicated below, and the depository institution below to credit the same to such account.

I (we) hereby request a change to my (our) existing direct deposit as indicated below.

Note: Please allow 5 business days for ACH processing to become effective.


Individual/Vendor Information - Please fill out the information below.


Depository Information - Please fill out the information below.

Checking Account

Savings Account


This authorization is to remain in full force and effect until the company has received written notification from me (or either of us) to discontinue direct deposit. Please allow 15 business days for processing of ACH discontinuation.

Upload a "voided" check in the box below or a bank Direct Deposit Form:

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We do not store your credit card information.*

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