Bank Draft Form printable pdf download

Mississippi Affordable College Savings

MACS Program

Electronic Banking Form

Questions? Call toll-free 1-800-486-3670

P.O. Box 55037, Boston, MA 02205-5037

Visit

Instructions

Complete this form to add, change or stop the Automatic Contribution Plan (ACP) and/or Electronic Purchase Option on your Account, or



to add or change your bank account information for contributions by electronic bank transfer.

A Signature Validation Program (SVP) Stamp is required for entity Accounts and may be required for Accounts for which the individual



completing this form is acting in a legal capacity as a representative of the individual Account Owner as described in Section 5

Unless a Signature Validation Program Stamp (SVP) (or Medallion Signature Guarantee)

is affixed to this form, any change in your bank



account information will result in a 30 day hold on withdrawals from your Plan Account to the new/modified bank account.

Print in all capital letters using blue or black ink.



Forms may be downloaded at the Plan’s website at

or you may call the Plan toll-free at 1.800-486-3670 to order forms,

perform certain account transactions, or to get help completing a form.

Account Information

(You must provide all requested information.)

Account Number (Refer to your statement.)

Account Owner or Custodian Name (First, MI, Last, Suffix), or Entity Name

Beneficiary Name (First, MI, Last, Suffix)

What would you like to do?

(Check all that apply.)

Automatic Contribution Plan (ACP)

Make pre-scheduled, recurring contributions to your Account directly from your bank account.

Allow up to 10 business days to initiate or modify ACP.



Establish ACP

Modify ACP

banking

ACP

Change

Delete

(Complete Sections 3, 4

(Complete Sections 3

(Complete Sections

(Check this box and

and 5)

4 and 5)

complete Section 5)

Electronic Purchase Option

Make one-time purchases or withdrawals from or to your bank account.



Allow on my Account

Change banking

Delete this Option

(Complete Sections 4

(Check this box and

and 5)

and 5.)

complete Section 5.)

Automatic Contribution Plan (ACP) Instructions

If you elect to participate in the Automatic Contribution Plan (ACP), funds will automatically be transferred from your bank account in the

amount and frequency you indicate below. Provide all requested information in this section. If you do not already contribute to the

Investment Portfolio you select, check the appropriate box and a new Investment Portfolio will be opened for you.

It can take up to 10 business days to initiate ACP.



Select the frequency of your contributions.

If none selected, then your bank withdrawals will occur monthly.



Bi-weekly



Monthly



Quarterly



Select the month(s) of your contributions.

If none selected and your frequency is quarterly, then your bank withdrawals will occur every calendar quarter.



Jan.



Feb.



Mar.



Apr.



May



Jun.



Every Month

(or →)



Jul.



Aug.



Sep.



Oct.



Nov.



Dec.

Signature Validation Program (SVP) Stamps are available from banks or trust companies, savings banks, savings and loan associations or members of a

national stock exchange and warrants that the signer of this form is the appropriate person to provide instruction for this account. A notary public cannot

provide a Signature Validation Program (SVP) Stamp. Please contact your bank or broker, if needed.

Medallion Signature Guarantees and Signature Validation Program (SVP) Stamps are available from banks or trust companies, savings banks, savings and loan

associations or members of a national stock exchange and warrants that the signer of this form is the appropriate person to provide instruction for this account. A

notary public cannot provide a Medallion Signature Guarantee or a Signature Validation Program (SVP) Stamp. Please contact your bank or broker, if needed.

Bank Draft Form

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