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Authorization for Direct Deposit with the Partnership for Community Action (PCA), fiscal sponsor for Deconstructing Racism New Mexico (DRNM)

DRNM is required by PCA to have individuals and organizations "set up" direct deposit or automatic payment from PCA's bank to the bank (or other cash application) of the individual or organization. Please note the information (names) on the W9 and direct deposit must match.

To authorize direct deposit, simply complete and submit this form. Please note you must include a "screenshot" of your account information including 1) Legal First and Last Name or Organization Name (same as your W9), 2) account number and 3) routing number. 

I hereby authorize the Partnership for Community Action to deposit any amounts owed to me, by initiating credit entries to my account at the financial institution (hereinafter "Bank") indicated on this form.

Further, I authorize Bank to accept and to credit any credit entries by the Partnership for Community Action to my account. In the event that the Partnership for Community Action deposits funds erroneously into my account, I authorize the Partnership for Community Action to debit my account for an amount not to exceed the original amount of the erroneous credit. This authorization is to remain in full force and effect until the Partnership for Community Action and Bank have received written notice from me of its termination in such time and in such manner to afford the Partnership for Community Action and Bank reasonable opportunity to act on it.

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