2021-2022 Automated Clearing House (ACH) Electronic Debit Authorization
This form is to be used by the Girl Scouts of New Mexico Trails (GSNMT) for processing of Automated Clearing House (ACH) withdrawal payments for participating in GSNMT Product Programs for the 2021-2022 Membership Year which includes 2021 Fall Product Program and 2022 Girl Scout Cookie Program.
Sign in to Google to save your progress. Learn more
Email *
Troop Volunteers acknowledge and agree to: *
I Agree
Troop authorizes GSNMT to debit the troop bank account for the total of the Council Proceeds ONLY minus any Outstanding Balance Reports that have been submitted on or before the due date. Please refer to the Fall Product Program or Cookie Program Troop Guide for either deadline.
Outstanding Balance Reports MUST be submitted online no later than the date stated in either the Fall Product Program or Cookie Program Troop Guide along with all receipts. Failure to submit Outstanding Balance Reports by the due date will result in the balance becoming the responsibility of the troop.
Once payment is confirmed, the payment will be added to the troop deposit records in M2 Operating System for Fall Product Program or eBudde for Girl Scout Cookie Program. Please allow 5 to 7 business days for the transactions to appear in your bank account.
Troop is responsible for informing the GSNMT Product Program Department if bank account information has changed since the 2021 Girl Scout Cookie Program or any time during the 2021-2022 Girl Scout year. This includes providing either a voided troop check or letter or document from bank showing full bank account number and routing number for automated withdrawals prior to the deadline in Troop Guide for either the Fall Product Program or Cookie Program.
Has your troop changed banks, had a bank name change, or opened a new troop bank account since the 2021 Girl Scout Cookie Program? *
Service Unit *
Troop Number *
Bank Name *
Last Four Digits of Troop Bank Account Number *
Full Legal Name *
Position in Troop *
Email Address *
Phone Number *
This authorization must be signed by an authorized bank account signer for the troop.
I am an authorized bank account signer and consider this my electronic signature with my name below. *
Today's Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy