Bank Account Authorization Request Form

Bank Account Authorization Request Form

To be submitted to request authorization to open a new troop/service unit bank account or to change a signer on an existing troop/service unit bank account. Please allow five (5) business days (or more during Fall/Cookie Sale) processing time.
Please Select the Reason for this Submission: *

Requesting to Open a Bank Account for a New Troop/Service Unit Requesting to Change Signers on Existing Bank Account Requesting to Switch Banks
Name of Financial Institution You Are Leaving *
Reason for Leaving Current Financial Institution *
Name of Financial Institution You Plan on Using: *
This Form is Related to a: *

Troop Service Unit
Troop #####: *
Troop Meeting City: *
Troop Meeting State: *
Service Unit ###: *
Service Unit Name: *
Contact Information of Person Submitting Form: *

First Name Last Name
Email: *
Phone Number: *

Area Code Phone Number
Please list ALL authorized signers that you're requesting to be on your troop/service unit bank account.
Signer 1: *

Requesting to Add Requesting to Remove Confirming
Signer 1 Name: *

First Name Last Name
Signer 1 E-mail: *
Signer 1: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Signer 2: *

Requesting to Add Requesting to Remove Confirming
Sign 2 Name: *

First Name Last Name
Signer 2 E-mail: *
example@example.com
Signer 2: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Signer 3:

Requesting to Add Requesting to Remove Confirming
Signer 3 Name: *

First Name Last Name
Signer 3 E-mail: *
Signer 3: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Signer 4:

Requesting to Add Requesting to Remove Confirming
Signer 4 Name: *

First Name Last Name
Signer 4: E-mail *
Signer 4: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Signer 5:

Requesting to Add Requesting to Remove Confirming
Signer 5 Name: *

First Name Last Name
Signer 5 E-mail: *
example@example.com
Signer 5: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Signer 6:

Requesting to Add Requesting to Remove Confirming
Signer 6 Name: *

First Name Last Name
Signer 6 E-mail: *
example@example.com
Signer 6: *

Is a registered and approved Girl Scout volunteer Is not of the same family or living in the same household as another signer Has no financial restrictions
Terms of Agreement
By submitting this form, you and all the signers on your troop/service unit bank account acknowledge and agree to:
- Open only one (1) checking account with a federally insured financial institution. Savings accounts are prohibited.
- Maintain two (2) registered and approved Girl Scout volunteers as signers on the account that are not of the same family or living in the same household as another signer and have no financial restrictions. The council CFO and Controller will also be authorized on the account.
- Submit all account changes to GSDH via a new Bank Account Authorization Form submission for approval.
- Submit a Bank Account Confirmation / ACH Form annually by October 1st and/or within ten (10) business days of opening or making any changes to your troop/service unit bank account.
- Submit a Finance Report by June 15th of each year.
- Maintain accurate record keeping and a positive bank account balance.
- Obtain two signatures for any expenditure in excess of $500.00.
- Obtain debit cards (optional) with a purchase limit of $500.00. Debit cards may not have cash-withdrawal capabilities.
- Communicate regularly with girls/caregivers/sponsors regarding where funds come from and how they are spent.
- Follow all other Troop and Service Unit Funds Policies and Document Retention and Destruction Policies which can be found under forms on the GSDH website.
What happens next...

If we have any questions regarding your submission you will be contacted by your troop/service unit's Member Supoort Specialist. If there are no questions regarding your submission you will receive a Bank Account Authorization Letter and Corporate Bank Resolution from Finance to present to your financial institution as authorization to open a new troop/service unit bank account or make changes to your existing troop/service unit bank account. Please do not go to your financial institution prior to receiving these forms.

Please allow five (5) business days (or more during Fall/Cookie Sale) processing time. If you have any questions regarding your submission please reach out to our Member Services Center at help@gsdakotahorizons.org or 1.800.666.2141.
Should be Empty:

Bank Account Authorization Request Form

Please list ALL authorized signers that you're requesting to be on your troop/service unit bank account.

Terms of Agreement