Individual Coaches Payment Form ⋆ U.S. Baseball Academy

ACCOUNT CODE

*INTERNAL USE ONLY (U.S. BASEBALL & SOFTBALL ACADEMY)

ACCOUNT CATEGORY

*INTERNAL USE ONLY (U.S. BASEBALL & SOFTBALL ACADEMY)

COACH PAYMENT FORM (Individual)

Please complete and double check all information to avoid delays.

Camp Code *

(This code is listed on the money breakdown form. It is an internal code used for processing payments. Please enter the code exactly as listed.)

CAMP NAME *

(This is the name we use to identify the camp on-line and in our accounting system. Please enter the name exactly as listed on the money breakdown form. )

PAYEE INFORMATION

Will this payment be made to an individual or business/organization? *

Individual
Business/Organization

Name *

BUSINESS/ORGANIZATION NAME: *

Payment Amount: $ *

Check appropriate box for federal tax classification: *

SSN OR FEDERAL ID #

Email *

Phone

Please enter your mailing address below: *

Address Line 1

City

State

Zip Code

Option 1 - ACH requires completion of bank routing and account information below using secure submission form. This is the recommended and preferred method as the quickest and most reliable way to receive payment. Processing time is 3-5 business days.

Option 2 - Mailed payments require additional processing time. The finance team will process checks within 7 days of the end of camp. The expected transit time is 10-14 days.

Please choose one of the following pay options (Click the image to make your selection): *

ACH (DIRECT DEPOSIT TO YOUR BANK ACCOUNT)
Mailed Check from USBSA

*Tipalti is the accounting software used to initiate and send payments. ACH payments can be sent to any U.S. Bank as long as you provide a nine digit routing number and valid checking or savings account number.

BANK INFORMATION

NAME ON ACCOUNT: *

BANK NAME:

ROUTING #

ACCOUNT #

DIRECT DEPOSIT: Signature *

Clear Signature

USBSA, LLC is hereby authorized to direct deposit my pay to the account listed above. This authorization will remain in effect until I modify or cancel in writing:

INDEPENDENT CONTRACTOR AGREEMENT: Signature *

Clear Signature

By signing the line above, the coach agrees that he/she is an independent contractor and not an employee. USBSA, LLC. will not withhold from payment any taxes, which shall be the sole responsibility of the coach. As an independent contractor, the coach is entitled to no other benefits or payments from USBSA, LLC. Further, the coach understands the suggested drills and all other materials associated with the program are the property of USBSA, LLC.

DATE *