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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 15 business days for ACH processing to become effective.


Individual/Vendor Information - Please fill out the information below. Name submitted must be on the account. 


Depository Information - Please fill out the information below.


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.

Please upload a direct deposit form from your bank or a screenshot of your routing/account number (voided check):

Please upload a W9 below. If you currently have a W9 on file with FYSA please confirm with Michelle Cook at finance@fysa.com.

A copy can be found HERE

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We do not store your credit card information.*

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