1
Account Information
  • Account Owner or Custodian First Name*
  • Beneficiary First Name*
  • Email
  • Last Name*
  • Last Name*
2
Deposit Information
Apply this deposit:
Towards the purchase of a NEW CD or Savings Account. Note, if a Savings Account already exists, the deposit will be applied to the existing
Savings Account.
Towards an EXISTING CD or Savings Account.
  • Account Type*
    Maturity Year(s)*
  • 529 Account Number (only if for existing account)
    Deposit Amount*
Additional contributions ($25 minimum) may be made to existing CDs under the same terms and conditions as the original CD. Additionally, the maturity date of any additional contributions will match the maturity date of the existing CD.
3
Deposit Options
  • Deposit Option (Mimimum - E-Check: $25; Direct Deposit $25)
  • Direct withdrawal from your personal checking or savings account.
    Financial Institution Name*
    Account Number*
  • Checking   Savings
    ABA Routing Number*
4
Authorization
(Customer verification qualified by accessing our secure Online Banking portal. Please initial and date.)
By completing below, I certify this deposit is for the intended qualified higher education expenses of the Beneficiary. If this is a rollover, I understand my contribution will be treated as earnings until the Plan receives appropriate documentation from me.
  • Depositor’s Full Name
  • Date (MM/DD/YYYY)
  • Account Owner/Custodian   Other