ACH Debit Form

This form provides a permanent authorization for GSNorcal to initiate product ACH transfers from your troop bank account.

As an authorized signer on the financial institution account identified below, I authorize Girl Scouts of Northern California (GSNorcal) to initiate electronic ACH (Automated Clearing House) transfers to debit or credit the account identified below for financial transactions relating to Product Programs.

I also authorize GSNorcal to repeat any debit that fails for any reason, and understand the troop will be responsible for non-sufficient funds bank fees. This authorization remains in effect for as long as the troop is active and the account remains open.

Troop Information

Troop Bank Information

Type of Account: *

Signature and Acceptance

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