ACH Debit Request Authorization Form
This form is used by employers to authorize Alerus Financial to transfer (debit) funds from their bank account via Automated Clearing House (ACH). It is also used to update banking information or add new products. Ensure you complete all required fields and retain a copy for your records.
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How do I fill this out?
To fill out this form, you will need to gather specific information about your employer and bank account. Begin by providing employer details, followed by program identification, and finally complete your banking information. Ensure all required fields are filled out accurately.
How to fill out the ACH Debit Request Authorization Form?
1
Begin by entering your employer information in section 1.
2
Select the applicable program in section 2.
3
Complete the banking information in section 3.
4
Sign and date the form in section 4.
5
Submit the completed form as directed.
Who needs the ACH Debit Request Authorization Form?
1
Employers needing to authorize ACH debits for employee retirement contributions.
2
Employers updating their banking information for ACH transactions.
3
Employers adding new products to their ACH transactions.
4
HR managers responsible for handling employee retirement accounts.
5
Finance departments managing payroll deductions and contributions.
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What are the instructions for submitting this form?
To submit this form, please ensure all required fields are completed accurately. You can upload the completed form using the Submit File feature in the Employer Portal, or return it to your MERS contact along with adoption documents. For any questions, you can contact Alerus Retirement Solutions at Two Pine Tree Drive, Suite 400, Arden Hills, MN 55112, fax at 651.746.6142, or through the online submission form on their website. It’s important to retain a copy of the completed form for your records.
What are the important dates for this form in 2024 and 2025?
There are no specific important dates for this form in 2024 and 2025 as the form can be submitted at any time when required.
What is the purpose of this form?
The purpose of the ACH Debit Request Authorization Form is to facilitate the automatic transfer of funds from an employer's bank account to Alerus Financial for retirement plan contributions, including loan payments. This form ensures that the correct amount, as indicated in the payroll contribution file, is debited periodically from the employer's account. By completing and submitting this form, employers can streamline the process of managing retirement plan contributions and maintain accurate financial records. Furthermore, this authorization allows employers to adjust or correct any entries as needed, providing flexibility and ensuring the accuracy of transactions.
Tell me about this form and its components and fields line-by-line.
- 1. Employer name: The name of the employer authorizing the ACH debit.
- 2. Employer address: The address of the employer authorizing the ACH debit.
- 3. City: The city where the employer is located.
- 4. Phone: The phone number of the employer.
- 5. Email: The email address of the employer.
- 6. Program identification: Select the applicable program for the ACH debit.
- 7. Bank name: The name of the bank where the employer's account is held.
- 8. Retiree Health Funding Vehicle: The retiree health funding vehicle information.
- 9. Municipality number: The municipality number associated with the employer.
- 10. State: The state where the employer's bank is located.
- 11. Zip: The ZIP code of the employer's bank.
- 12. Bank address: The address of the employer's bank.
- 13. ABA/Routing number: The ABA/routing number of the employer's bank.
- 14. Account number: The account number of the employer's bank account.
- 15. Checking/Savings: Indicate whether the account is a checking or savings account.
- 16. Debit Block: Indicate if there is a debit block on the account.
- 17. Signature: The signature of the authorized employer representative.
- 18. Date: The date the form was signed.
- 19. Printed name: The printed name of the authorized employer representative.
- 20. Title: The title of the authorized employer representative.
What happens if I fail to submit this form?
Failure to submit this form may result in delays or interruptions to the automatic transfer of funds for retirement plan contributions.
- Delayed Contributions: Without this authorization, retirement plan contributions may be delayed.
- Manual Processing: Employers may need to manually process contributions, leading to increased administrative effort.
- Banking Information Errors: Incorrect or outdated banking information may result in failed transactions.
How do I know when to use this form?
- 1. Authorizing ACH Debits: Authorize Alerus Financial to debit funds from your bank account via ACH.
- 2. Updating Banking Information: Update your banking information for ACH transactions.
- 3. Adding New Products: Add new products to your ACH transactions.
- 4. Managing Retirement Contributions: Streamline the process of managing retirement plan contributions.
- 5. Ensuring Accurate Records: Maintain accurate financial records for retirement plan contributions.
Frequently Asked Questions
How can I fill out the ACH Debit Request Form?
You can fill out the form using PrintFriendly's PDF editor by entering the required information in the fillable fields.
Can I update my banking information with this form?
Yes, this form can be used to update your banking information for ACH transactions.
How do I sign the ACH Debit Request Form?
You can sign the form using PrintFriendly's 'Sign' option and adding your signature in the designated field.
Can I share the completed form with someone?
Yes, you can share the completed form via email or generate a shareable link using PrintFriendly's 'Share' option.
How do I save the edited form?
You can save the edited form by selecting the 'Save' option in PrintFriendly's PDF editor.
What information do I need to provide in the form?
You need to provide employer information, program identification, and banking information.
Is this form applicable to all divisions within a product?
Yes, the form applies to all divisions within the selected products.
How do I authorize payments if there is a debit block on my account?
Provide the Alerus Organization ID #145-0140105 to your bank to authorize payments if there is a debit block on your account.
What happens after I submit the form?
After submission, Alerus Financial will transfer (debit) funds from the bank account listed via ACH as authorized.
How long does the authorization remain in effect?
The authorization remains in effect until it is cancelled in writing.
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