EFT/Drafting Authorization Form

EFT or Drafting Authorization

EFT/DRAFTING AUTHORIZATION AND AGREEMENT

Please Select a Payment Option (mark a box)(Required)
**If draft is for a retirement contribution, please indicate what type of contribution (SRA, Roth, After-tax, or Employer). If multiple types, list each type and the amount for each.

PERSONAL INFORMATION

Full Name(Required)
Address(Required)

BANKING INFORMATION

VOIDED CHECK

**If you are updating the amount of your current bank draft only, you do not need to upload a voided check/official bank form. If you are updating banking information or submitting a new bank draft, please include a voided check or official bank form that includes routing and account number.
Max. file size: 2 MB.
Please scan in and upload a voided copy of your check or official bank form which includes routing and account number.
*Note: If any contribution (or any portion of a contribution) is made by a good faith mistake of fact, then within one year after the payment of the contribution, and upon receipt in good order of a proper request approved by the Board of Retirement, the amount of the mistaken contribution (adjusted for any loss in value) shall be returned directly to the participant or, to the extent required or permitted by the Board of Retirement, to the participating employer.

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