subject_line
TEXAS PTA Authorization Agreement
for Automated Clearing House Transactions (ACH Credits)
If you need assistance, please email finance@txpta.org
Security of your bank account information: learn more
here
.
PTA Information
PTA Name
Please use full name, no abbreviated names will be accepted.
*
Texas PTA ID#
Your PTA's ID # can be found in your bylaws or visit the
Local PTA Roster
. It is the same ID# that is used when submitting a membership roster. If you are not sure of your PTA ID#, please call 1-800-TALK-PTA or email memberservices@txpta.org Thank you!
*
🛈
School District (ISD)
Please use full name, no abbreviated names will be accepted.
*
Bank Information
Bank Name
*
Branch
(if applicable)
City
*
State
*
Texas
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Transit/ABA Number
(Routing #)
*
Account Number
*
Submitter Information
First Name
*
Last Name
*
PTA Role
*
President
Treasurer
Other
Other
In order for Texas PTA to fulfill this request, your PTA must have a regisered President on file. If you have not already registered, please go to this
link
to register as an executive board member.
In order for Texas PTA to fulfill this request, your PTA must have a regisered President on file. Please go to the
Local Roster
to verify that your President has registered themself. All leaders can register themselves at the link on
this page
.
Phone Number
*
Email
*
President's First Name
*
President's Last Name
*
President's Email
*
Automated Payment Program & JoinPTA.org Agreement
Automated Payment Program Participation
*
I am not currently participating . ADD -Credit the account shown.
I am currently participating. CHANGE -Change bank information.
I hereby authorize Texas PTA to initiate credit entries and, if necessary, to initiate debit entries and adjustments for any credit entries in error, to the named PTA Checking Account indicated below and the depository named below, to credit and/or debit the same to such account.
*
Yes
I understand that this authority is to remain in full force and effect until Texas PTA has received written notification, to finance@txpta.org, from an officer of the named PTA of its termination, in such time and in such manner as to afford Texas PTA and the named PTA a reasonable opportunity to act on it.
*
Yes
JoinPTA.org Participation
*
Yes, allow people to join my PTA on www.joinpta.org
No, do not allow people to join my PTA on www.joinpta.org
Upload a copy of a voided blank check, direct deposit form from bank or printed bank documentation of bank's routing number and your PTA bank account number.
I wish for this transaction to take place starting on this date and to recur as necessary.
*
+
Signature
*
clear