Bank Verification Form

This form lets a financial institution confirm a borrower's bank account details, including account type, account age, and whether direct deposit is set up, with sign-off from a bank representative.

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Section

Borrower's Name

Nombre

Apellido

Reference Number

I authorize you to release the following information requested by ABC Financial, concerning my bank account with your bank.

I authorize I do not authorize

Section

Financial Institution Name (Bank, Credit Union, etc.)

Bank Address

Dirección

Ciudad

Estado / Provincia

Código postal

Borrower's Routing Number

Account Number

Date This Account Was Opened

Type of Account

Checking Savings Other

Does this account accept ACH debits?

Yes No

Has this account been open for at least three months?

Yes No

Does borrower have direct deposit into this account?

Yes No

Bank Representative's Signature

Sign here

Date This Account Was Opened

Bank Representative's Name

Nombre

Apellido

Bank Representative's Phone Number

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