Automatic Deposits

At United Way of the River Cities, we want to make it easy and efficient for you to receive reimbursements or payments. By filling out the Authorization Agreement for Automatic Deposits, you’re choosing a secure and convenient way to have funds deposited directly into your bank account. Simply complete the form and submit it as instructed—no more waiting on paper checks!

 

Organization Address(Required)
I (we) hereby authorize United Way of the River Cities, Inc., hereinafter called UNITED WAY, to initiate credit entries to my (our) Checking Account or Savings Account indicated below at the depository financial institution named below, hereinafter called DEPOSITORY, and to credit same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.(Required)
Financial Institution Address(Required)
This authorization is to remain in full force and effect until UNITED WAY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
Name(Required)
Signature(Required)
NOTE: ALL WRITTEN CREDIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MAY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION.