Wabash Valley Online Application Consortium - Direct Deposit Authorization (Update)
Direct Deposit Authorization (Update)
Organization:
Wabash Valley Online Application Consortium
Assigned To:
Public User
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Please answer the questions below.
I authorize West Lafayette Community School Corporation to send credit entries, as well as appropriate adjustments and debit memos, to my account(s) as follows. This authorization will remain in force until cancelled in writing or changed by a new request.
Primary Account:
Account Type:
Checking
Savings
Institution Name:
Routing Number:
Account Number:
Percentage or amount to be deposited into this account:
Secondary Account:
Account Type:
Checking
Savings
Institution Name:
Routing Number:
Account Number:
Percentage or amount to be deposited into this account:
Please upload a voided check or other confirmation of routing number and account number for each account here:
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By typing in your name (your “eSignature”), you accept and consent to be legally bound by this document’s statements, terms and conditions as if this document was signed by you in writing with pen on paper. You agree that no third party or other means of verification is necessary to validate your eSignature and that the lack of such third party or other means of verification will not in any way affect the enforceability of this document.
Date:
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History
Step:
Someone fills out the form
Sent To: Public User, On:
4/18/2025 6:00:26 PM Eastern Standard Time