2023 NEW Member Application - Financial Institution

Company Information:

Organization
Address
City State Zip
Phone
Fax
Website
Member Type
Institution Type
ABA Routing Number

Key Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Executive Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Billing Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Operations Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Compliance or Audit Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Card Operations Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Check Operations Contact Information:

First Name Last Name
Title
Your Email
Your Phone

Wire Operations Contact Information:

First Name Last Name
Title
Your Email
Your Phone
The institution named above makes this application for membership to PaymentsFirst, and herin agrees:
1. To be bound by the Nacha Operating Rules and other payment regulations.
2. To pay member dues levied by the PaymentsFirst Board of Directors annually. Membership dues will be due each year on January 1.
3. Unless otherwise terminated by PaymentsFirst, this membership is to remain in full force and effect until the Organization has given PaymentsFirst 90-days written notice of its membership termination.
4. Dues are non-refundable once the current billing year is in force.
I (we) hereby agree to the terms above.
Accept by inserting initials
   - denotes required fields