Authorization to Receive ACH from MNUMC

This form is to receive electronic payments from the MN Conference of the United Methodist Church.

Information as it appears on the account to receive funds:
*Name of Church of Individual
*Complete Address
*Bank routing number

9 digits before the colon

*Bank account number

Digits after the colon

*Type of account
Attach proof of ownership

Scan of a voided blank check, bank statement, or other document

If you prefer, mail this document to: Finance and Administration, Minnesota Annual Conference of the United Methodist Church, 122 W. Franklin Ave., #400, Minneapolis, MN  55404

Attach file pdf, doc(x), xls(x), jpg/gif/png, ppt - up to 25 MB

Contact information for authorized person on account
*I authorize the Minnesota Annual Conference of the United Methodist Church to make payments via ACH to the account specified.

This authorization continues until revoked in writing.

*First Name
*Last Name
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