Bank Account Information Form

Using this online form saves time and precious resources! You still have the option to print and mail a form to our office.

If you have any questions, please email us or call 402.558.8189.

Troop or Service Unit Information

Account Signers

Must list all authorized signers on this account.

Signer 1

Signer 2

Signer 3

Financial Institution Information

Authorized Signature

I certify that I am the owner or joint owner of the account(s) designated and am entitled to provide this information. I authorize Girl Scouts Spirit of Nebraska to initiate electronic credit entries and, if necessary, debit entries and adjustments for any credit entries in error to my account(s) listed above as well as any debit entries for product sales or other amounts owed the council. By signing this form, I am also giving consent to the above named Financial Institution to disclose/discuss this bank account information with Girl Scouts Spirit of Nebraska’s Finance Department. This authorization will remain in effect until this account is closed.

NOTE: This form will be presented to our banks upon their request. If any changes are made to your troop or service unit bank account, a newly signed and dated form must be submitted to the Finance Department. These changes include adding or changing signers on an account.

Co-Leader or SU Manager's Signature: *
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