Bank account verification form 2025

1. Click ‘Get Form’ to open the bank account verification form in the editor.
2. In Section A, enter your name (Last, First, Middle Initial) and reference number. Indicate your authorization for information release by selecting 'Yes' or 'No'. Sign and date the form.
3. Move to Section B, which must be completed by a bank representative. They should fill in the financial institution name, address, state, routing number (9 digits), and account number.
4. The bank representative must answer whether the account has been open for three months and if it accepts ACH debits. Additionally, confirm if there is direct deposit into this account.
5. The bank representative should sign and print their name, provide their phone number, and indicate the type of account (Checking or Savings).
6. Finally, ensure that a stamp is placed in the designated section to verify the information before faxing it to Progressive at 1-877-966-2888.

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