Troop Bank Account Information

Troop/Group or Service Unit #

Service Unit #

Date

Please check the appropriate box for this account:

New AccountChangesNo ChangesAccount Closed

If the account is closed, please specify the date that it was closed

Date

Funds remaining $blanks were transferred to blank on date:Date or to GSGWM on: Date.

To be completed even if there are no changes to the account

Bank Name:

Branch Telephone Number:

Branch Address:

Account Number:

Routing Number:

Signers

There must be a minimum of three signers on the account, all of whom must be registered Girl Scout volunteers who are NOT related or in the same household. One signer must be the COMMUNITY ACCOUNTING COORDINATOR

Account Signer #1 Name:

First NameLast Name

Account Signer #1Phone Number:

Area CodePhone Number

Account Signer #1Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Account Signer #1 Signature:

Clear

Account Signer #2 Name:

First NameLast Name

Account Signer #2 Phone Number:

Area CodePhone Number

Account Signer #2 Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Account Signer #2 Signature:

Clear

Community Accounting Coordinator Name:

First NameLast Name

Community Accounting Coordinator Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Community Accounting Coordinator Phone Number:

Area CodePhone Number

Community Accounting Coordinator Signature:

Clear

Additional Notes/Information you wish to include:

Complete this form by Oct 31, or within two weeks of changing signers or opening a new account. NOTE: When you are reporting a closed account with a remaining balance, the balance must be forwarded to
GSGWM with this form.
New Accounts are required to attach a voided check or a deposit slip with this form.
(this is used to confirm the correct bank account # is listed)
As signers on this account, be aware GSGWM authorized to access any information about this account and to initiate debit and /or credit entries to this same account.

New Accounts attach photo of voided check or deposit slip here:

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Council Finder

Troop Bank Account Information

2023-2024 Group & Service Unit Bank Account Information