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Business ACH & Payroll Form
Business Name
(Required)
DBA Name (if applicable)
Contact Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
What is your role in the company?
(Required)
Owner
Manager
Employee
Other
Do you have an existing UCCU business account?
(Required)
Yes
No
Please tell us about your business; i.e, business type/industry
(Required)
Who do you plan on paying with this service?
(Required)
ACH (Paying Vendors)
Payroll (Direct Deposit for Your Employees)
Both ACH & Payroll
ACH Services
How much do you anticipate paying per month?
(Required)
What is the maximum amount you would pay to all vendors in a single day?
(Required)
Payroll Services
How often do you anticipate paying per month?
(Required)
Weekly
Every Other Week
Monthly
Other
What is your average payroll amount per period?
(Required)
$0 – $5,000
$5,001 – $20,000
$21,001 – $50,000
$50,001 – $75,000
$75,001 – $125,000
$125,001+
ACH & Payroll Services
How much do you anticipate paying vendors via ACH per month?
(Required)
What is the maximum amount you would pay via ACH to all vendors in a single day?
(Required)
How often do you anticipate paying payroll per month?
(Required)
Weekly
Every Other Week
Monthly
Other
What is your average payroll amount per period?
(Required)
$0 – $5,000
$5,001 – $20,000
$21,001 – $50,000
$50,001 – $75,000
$75,001 – $125,000
$125,001+
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