Product Program intent to ACH

GSOSW Product Program intent to ACH

form # | 07/25
This agreement grants permission for GSOSW to deduct funds that would usually be deposited into the GSOSW account on behalf of the troop for funds owed to council for participation in the Fall Product Program or Cookie Program.

A new form must be submitted for each new Girl Scout year.

Troop acknowledges and agrees to:
1. GSOSW will debit the troop bank account according to the dates in each program guide:
Fall Program - November 28

Cookie Program - 50% Initial Order due date - February 27, Final Deposit due date March 19, 2026
1. Troop is responsible to deposit sufficient funds to cover these debits.
2. Troop authorizes GSOSW to repeat debits that fail for any reason.
3. Troop agrees to work closely with GSOSW to pay all amounts due to council in any manner agreed to by both parties.
4. Troop with families with outstanding balances must submit a Missing Funds Report to the Product Program Department by 5:00 p.m. by the date listed in the TPM Manual.
Name

First NameLast Name
Email Address
example@example.com
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Position
Service Unit #
Troop Number
Name of your Bank Institution
Last 4 digits of Account Number
ACH our troop account for:
This authorization must be signed by an authorized check signer for the troop.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

GSOSW Product Program intent to ACH