Financial Institution Membership Application

As a UMACHA member, you will receive the ACH Rules, electronic and paper newsletters, workshop/webinar schedules, publication lists and other information to assist you with your ACH program.
Complete the form below to become a member of UMACHA and take advantage of all the member benefits. We use email as a primary source of delivery so you receive up-to-the-minute information. Please remember to let us know whenever you have changes in your contact information so you continue to receive all of the updated information UMACHA sends.

Financial Institution Information

Routing No.
FI Name
Address
City State Zip
County
Work Phone Fax Toll Free
Web
Asset Size

Primary Contact

First Name Last Name
Title
Email
Direct Dial Mobile

Membership Dues

The initial application fee is the annual dues base fee, which will provide membership benefits through the end of this current year. Annual dues will be reassessed annually each January; and the financial institution will be billed for the base dues fee of $300 plus per item fees based on ACH volume of the previous year.
Select Base Dues Amount
The institution stated above makes this application for membership in UMACHA and herein agrees:
1)it is a financial institution authorized by law to accept deposits, or is a holding company of one or more financial institutions authorized by law and its own governing rules to accept deposits; and is ensured or guaranteed by the Federal and/or a State government,
2)it is in compliance with and agrees to be bound by the Articles of Incorporation and Bylaws of UMACHA and the NACHA Operating Rules; and,
3)to pay all dues as levied by the Board of Directors of UMACHA and member specifically authorizes the collection of these dues through the Automated Clearing House Network.
I understand that by providing the above information, I consent to receive communications via mail or email sent by or on behalf of UMACHA.
By submitting this application, our company agrees to pay the current annual membership base fee of $300 to UMACHA, plus per item fees charged depending on volume.
I verify that I am an authorized representative of the company.
  (please initial here)

Other Contacts

1st Contact
Name
Title
Email
Phone

2nd Contact
Name
Title
Email
Phone

3rd Contact
Name
Title
Email
Phone
NOTE: If you have additional contacts at your organization, please notify the UMACHA office so they can be added to the database.
   - denotes required fields