Banking Information Form

Welcome to our Banking Information Form. We are transitioning our accounts payable and grant payments from checks to ACH transfer, so that payments will be directly transferred to your bank account.

We ask that you please fill out to the information below in order to process your payment.

If you have any questions, please email Accounting Assistant Victoria Kimmel at vkimmel@cfalleghenies.org.

Organization Name(Required)

Organization Address(Required)

Street Address Address Line 2 City State ZIP Code

Contact Name(Required)

First Last

Phone(Required)

Email(Required)

Bank Name(Required)

Bank Address(Required)

Street Address Address Line 2 City State ZIP Code

ABA Routing Number(Required)

Bank Account Number(Required)

Account Type(Required)

Checking

Savings

Account Verification(Required)

Max. file size: 1 GB.

Please provide a copy of a voided check or a letter from your bank providing confirmation of your account information.

Authorization(Required)

By typing your name below, you confirm that you are authorizing Community Foundation to begin transferring all future payments to the account mentioned above.

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