NMJC Foundation - Agency Accounts
Memo to Change Account
To change the name of the authorized person(s) for the Agency Account, please complete this form.
Memo to Deposit to Account
To deposit funds into your Agency Account, please complete this form.
Memo to Withdraw/Pay from Account
To withdraw funds from your agency account, please complete this form.
Reimbursement: If you have made a purchase with your NMJC credit card that needs to be reimbursed,
please complete this form and enter the entire 17-digit account number (Example: 11000-XXXX-71131-XXX).
Pay Invoice: If you need an invoice to be paid from your Agency Account, please specify who to
pay when completing this form.
All transactions must be accompanied by supporting documentation/receipts.
