Kinum ACH Remittance Authorization

Company Information:

Company Name: (required)

Bank Name: (required)

Routing Number: (required)

Account Number: (required)

Account Type (required)
Checking accountSavings account

Who is your Kinum Account Representative? (OPTIONAL)

Primary Contact:

Your Name: (required)

Your Email: (required)

Phone (required)

Authorized Signature:

Please sign with touchpad or touchscreen: