Company Name* (Company) hereby authorizes NeuBridg, Inc. & Douglas & Co. (Great Western Trust Department) to initiate debit/credit entries to the Originating Depository Financial Institution (Section 1) account shown on the NEUBRIDG, INC. INITIATED ACH MASTER BANKING AGREEMENT form for the following payroll period.
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NOTE: If the form is received before 3:00 PM CST, the funds will be withdrawn from your account on the next banking day. ALL documents received after 3:00 PM CST shall be processed the following business day, and withdrawal of funds shall occur on the date which complies with the bank’s ACH guidelines. Ample time is required to process all ACH requests, so there is no guarantee of the exact date of withdrawal.
NeuBridg, Inc. | PO Box 65308 | West Des Moines, IA 50265 | p (515) 309.2950
©2020 NeuBridg, Inc. All Rights Reserved NB Initiated ACH Request Ver 112822.214.171.124 Released: 11/2020