Cookie Program ACH Debit Authorization

  • Troop number should be 5 digits, no "#" or "-" symbols in the number please. Ex: 00123, 01416, 15224.
  • Bank Information

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  • Or a letter from bank that includes troop number, routing number, and account number.
  • This form is to be used by all GSGLA Troops to authorize ACH debit transactions during the GSGLA Cookie Program (required). A VOIDED TROOP CHECK (OR A LETTER FROM BANK THAT INCLUDES TROOP NUMBER, ROUTING NUMBER, AND ACCOUNT NUMBER) MUST BE UPLOADED TO THIS FORM.
  • Troop acknowledges and agrees to ACH:
    1. GSGLA will debit the troop checking account according to the instructions provided during training for the current year’s Cookie Program.
    2. The monies due for all Council proceeds will be debited in February and March (see Troop Guide for specific information and dates).
    3. Troops are responsible to deposit sufficient funds to cover these debits, and will be responsible for any resulting non-sufficient funds (NSF) charges; signatories below agree to verify that troop funds are deposited into the bank account and available for withdrawal.
    4. Troop expressly authorizes GSGLA to repeat debits that fail for any reason.
    5. Troop agrees to work closely with GSGLA to pay all amounts due to Council in any manner agreed to by both parties.
    6. Troops understand that they may not participate in the Cookie Program until ACH Debit Authorization is received by the Council.
  • This authorization must be signed by two (2) authorized check signers for the troop.
  • Signatory 1

  • Date Format: MM slash DD slash YYYY
  • Signatory 2

  • Date Format: MM slash DD slash YYYY