Communities Foundation of Texas - ACH/Wire Enrollment Form for Payments

Domestic ACH/Wire Enrollment Form for Payments
If applicable, fill in your W-9 info here and upload the completed one below.
Accounts Payable InvoiceGrantsBothUnsure
What is the name of your contact at CFT/EDTX?

First NameLast Name
Payee Information:
Payee Name*
Legal Payee Name
Payee's Legal Address*

Address

Street Address Line 2

City, State & Zip CodeState / Province

Postal / Zip Code
Contact Name
Email Address for Payment Notifications*
example@example.com
Bank Information for ACH or Fed Wire:
Payee Bank Name*
Address

Bank Address

Street Address Line 2

Bank City, State & Zip CodeState / Province

Postal / Zip Code
ACH Routing Number*
Account Number*
For the Benefit of
CheckingSavings
Federal Wire Routing Number:
Fed Wire Routing Number
Account Number
For the Benefit of
Authorization:
Name*

First NameLast Name
Title
Email*
example@example.com
Direct Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
CFT may call you or your financial institution to verbally verify your information.
I am authorizing CFT to process payments to the above mentioned account.*

Clear
Date

MonthDayYear
Date
A copy of a voided check or letter from your bank providing confirmation of your account details must be submitted with this form. Please ensure the documentation provided matches the information provided above.
- File Upload*
  
  Voided check or bank letter is required for all payees. W-9 is required for all Accounts Payable payments.
  Cancelof
- Additional Documentation
  
  W-9, Federal Tax-Exempt Determination Letter, etc.
  Cancelof
- Should be Empty:

Domestic ACH/Wire Enrollment Form for Payments

Payee Information:

Bank Information for ACH or Fed Wire:

Federal Wire Routing Number:

Authorization: