Cornerstone Chapel

Vendor ACH/Direct Deposit Enrollment - FN002


Vendor/Payee Information
Vendor Name:
Vendor Address:
Contact Name:
Phone Number:
E-mail Address:

 

Financial Institution Information
Bank Name:
Bank Address:
Name on Bank Account:
Type of Account:
Account Number:
Routing Number:
(9 Digit Number)

 

I certify that the information provided on this form is correct, and I hereby authorize Cornerstone Chapel to electronically deposit payments to the bank account designated above. It is my responsibility to notify Accounting (accounting@cornerstonechapel.net or (703) 770-1500) immediately if I believe there is a discrepancy between the amount deposited to my bank account and the amount of the invoice(s) paid. I understand that I must notify Cornerstone Chapel in writing immediately of any changes in status or banking information. I understand that this authorization will remain in full force and effect until Cornerstone Chapel has received written notification requesting a change or cancellation and has had reasonable opportunity to act on it, which should take no longer than seven (7) to ten (10) business days.

Leave this empty:

Signature arrow


Signature Certificate
Document name: Vendor ACH/Direct Deposit Enrollment - FN002
lock iconUnique Document ID: 951cdf196969a3705980497480a33966a8e82ba7
Timestamp Audit
July 14, 2020 10:38 pm EDTVendor ACH/Direct Deposit Enrollment - FN002 Uploaded by Cornerstone Chapel - edocs@cornerstonechapel.net IP 174.196.150.172
July 14, 2020 10:39 pm EDTFinance Department - accounting@cornerstonechapel.net added by Cornerstone Chapel - edocs@cornerstonechapel.net as a CC'd Recipient Ip: 174.196.150.172
July 14, 2020 11:06 pm EDTFinance Department - accounting@cornerstonechapel.net added by Cornerstone Chapel - edocs@cornerstonechapel.net as a CC'd Recipient Ip: 174.196.150.172