WITHDRAWAL
A Participant may elect to make a withdrawal from its account at any time. The minimum withdrawal is $2,000. If a
withdrawal causes a Participant’s account to fall below the minimum required balance of $25,000, the ELCA
Foundation may close this account. The ELCA Foundation requires ten (10) business days from receipt of this form
to process a withdrawal. This form may be submitted by email to: elcafoundation@elca.org
.
Date:
Participant Number: Account Number: E
Participant Name:
Account Name:
Participant Mailing Address (as stated on the Participant Application) OR □ Check here if address is new.
Street Address:
City: State: Zip:
Phone Number: Email:
WITHDRAWAL AMOUNT REQUESTED: $ (Suggested minimum $2,000)
A check will be mailed to the address on file unless you complete the information below.
Deposit to: □ Fund A Account □ External Account (Including MIF and ELCA Credit Union accounts)
Account Name: _______________________ Account Number: ______________________________
Bank Name: __________________________ Routing Number: ______________________________
Bank name and routing number not required for Fund A account transfers.
REQUIRED AUTHORIZED PARTICIPANT REPRESENTATIVE SIGNATURE(S): Required signers must match those
listed on Form A: Participant Application or most recent Form C: Change in Authorization.
Name: Title: Signature:
Name: Title: Signature:
Name: Title: Signature:
FOR OFFICE USE ONLY:
[ ] Verify Account Balance: _______________
[ ] Verify Signatures: ____________________
Form revised July 2021
ELCA Foundation • 8765 West Higgins Road • Chicago, IL 60631
1.800.638.3522 or 773.380.2700 • elcafoundation@elca.org
Form E
May be submitted via email to:
elcafoundation@elca.org
