Make a Deposit
Authorize SEAM, LLC to process a withdrawal from your checking or savings account
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Our ACH Payment Process is changing. 
ACH Withdrawals will be a charged of $5.49 for processing and expenses related to these services, beginning 1/1/2024. 
The completion of this form authorizes Surrogacy Escrow Account Management, LLC, to withdraw the amount specified from the account indicated below, using ACH Receipt on or within 7 business days of the date listed below. This authorizes the financial institution holding the Escrow Account to post all such entries. I agree that the transactions authorized herein shall comply with all applicable U.S. Law. 

SEAM, LLC utilizes Google Workspace to keep your information secure. Your information is never shared and is not sent over email servers.
Relation to Escrow Account *
Escrow Account Name *
Identify the Escrow Account in which to allocate this deposit. 

(Account Name is IP Last name-GC Last name or IP Last name-DonorID)
Deposit Amount *
Please enter the amount you wish to deposit in US Dollars, with no dollar sign.
There is a $5.49 fee for this withdrawal. How should we apply this fee to your deposit? *
Enter the date in which the funds will be available for withdrawal:
Withdrawal requests cannot typically be processed as a same-day transaction and can occasionally take up to a week to be processed completely. Enter a date after today.
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Account Holder Name *
Routing Number *
Bank Account Number *
Account Type *
Email Address *
Phone Number *
Enter the phone number where you can be reached if the transaction is rejected or returned and we are unable to reach you by email.
Electronic Signature *
Electronic Signature Date *
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To complete the set-up, please click submit. Once you have seen the submission confirmation page, please close this browser tab or navigate to another page, or your information will continue to resubmit each time you open your browser.

You will receive an email from Horizon Bank confirming your deposit once it begins processing.

We will email you and update your statement upon deposit.
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