Please return completed form to: Girl Scouts—Dakota Horizons 1101 S Marion Road, Sioux Falls, SD 57106 605.336.2978 or 800.666.2141 Fax 605.336.6841 www.gsdakotahorizons.org Bank Account Authorization Form Date: Your name: Your email: Troop/service unit #: SU Name: Requesting an authorization to: q Open a new account q Change signers Choose your group type: qTroop q Report current signers q Service unit Authorized Account Signers Add, Remove or Report? q Add q Remove q Report Signers full name: Signer’s email: Authorized bank signer checklist: q Approved volunteer with Girl Scouts—Dakota Horizons q Registered member of GSUSA q Not related to the other signers of the account Add, Remove or Report? q Add q Remove q Report Signers full name: Signer’s email: Authorized bank signer checklist: q Approved volunteer with Girl Scouts—Dakota Horizons q Registered member of GSUSA q Not related to the other signers of the account Add, Remove or Report? q Add q Remove q Report Signers full name: Signer’s email: Authorized bank signer checklist: q Approved volunteer with Girl Scouts—Dakota Horizons q Registered member of GSUSA q Not related to the other signers of the account Add, Remove or Report? q Add q Remove q Report Signers full name: Signer’s email: Authorized bank signer checklist: q Approved volunteer with Girl Scouts—Dakota Horizons q Registered member of GSUSA q Not related to the other signers of the account Responsibility Agreement By submitting this form, you acknowledge that the signers for your troop/group bank account agree to: • Keep a minimum of two, unrelated, approved signers on the account • Only open one, small business checking account (no credit cards or multiple accounts) • Ensure spending decisions are agreed on by the troops/groups • Practice open-book record keep with girls and their parents/guardians • Never use Girl Scout funds for personal use or borrow from troop accounts for any reason • Submit an Annual Finance Report by May 31 each year Submit
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