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Merchant Bank Account Change Request
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Merchant Bank Account Change Request
Merchant Name
Merchant ID
Effective Date
Date Format: MM slash DD slash YYYY
Please complete the below sections. Attach a copy of a voided check using the tool at the bottom of the page. For all changes, the authorized signer must e-sign and date. Once completed and signed, click continue, and your documents will be submitted.
Bank Account Change
Current Bank Account
Checking
Savings
Bank Name
Routing Number
Account Number
New Bank Account
Checking
Savings
Bank Name
Routing Number
Account Number
Authorized Signer From Application
Owner/Officer Signature
Date
Date Format: MM slash DD slash YYYY
Owner/Officer Name
Owner/Officer Title