Direct Deposit Authorization (ACH)
To ensure faster and more efficient payments, please provide us with your banking information so we may directly deposit funds into your account.
ORGANIZATION INFORMATION
Are you submitting this form to share banking information:
For the first time?
As an update to previously submitted information?
Full Organization Name or Name of Individual
*
EIN (Employer Identification Number) or last 4 digits of SSN
*
No dashes, only numbers.
Organization Address
*
Street Address
Street Address Line 2
City
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
BANK INFORMATION
Bank Name
*
Bank Routing Number
*
Bank Account Number
*
Type of Banking Account
*
Business
Personal
Checking or Savings Account?
*
Checking
Savings
Please upload a copy of voided check.
*
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CONTACT INFORMATION
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I authorize direct deposit.
*
By checking this box, you are requesting The Pittsburgh Foundation to validate your bank information as well as authorize direct deposit payments to the account listed above. Please note that you may receive an email, telephone call or both to verify the above information.
Please verify that you are human.
*
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