Electronic Transfer of Funds Authorization Form
Association Name: ____________________________________________ Association Number: ___________
Address: _________________________________ City: ____________________ State: _____ Zip: ________
Telephone Number: ____________________ E-mail Address: ______________________________________
Internet E-mail: Our ability to support your questions and problems, and to get information to you about
WinLABS, is greatly enhanced when we communicate with you via Internet E-mail.
We, the undersigned representatives agree to participate in the electronic transfer of dues between our
local association and USBC Headquarters. We further agree to meet all requirements of this process set
forth by USBC.
President’s Signature: __________________________________________________ Date: ________________
Association Manager’s Signature: _________________________________________ Date: _______________
Select one of the following options:
Option 1 – We are already on WinLABS, our banking information is provided below.
Option 2 – Send WinLABS Software, our banking information is provided below.
Option 3 – We process by sharing a computer with a neighboring association or we process through
USBC Headquarters, our banking information is provided below.
Please fill out all of the banking information requested below. For the most efficient processing of your
request, please attach a voided check to this form, and disregard completing the banking information.
Bank or Savings & Loan Name: _______________________________________________________________
Bank/S&L Address: ____________________________ City: _______________ State: _____ Zip: ________
Type of Account (Check One):
Savings Account
Checking Account
Account Number: ________________________________ Branch: ___________________________________
Bank Routing Number (Must Be 9 Digits): ___ ___ ___ ___ ___ ___ ___ ___ ___
Wassv/USBC/Chartering/MergeCharter/ElectronicTransferofFundsAuthroiztionForm