Fidelity Investments Electronic Funds Transfer (EFT) Authorization Form Completed Form Examples and Samples
Explore real-world filled examples of the Fidelity Investments Electronic Funds Transfer (EFT) Authorization Form. Each sample demonstrates how to correctly complete the form with account details, bank routing numbers, transfer amounts, frequencies, and authorized signatures. Perfect for investors setting up automatic contributions, one-time transfers, or recurring investments with Fidelity.
Fidelity Investments EFT Authorization Form Example – Automatic Monthly Investment
How this form was filled:
This example shows a Fidelity Investments Electronic Funds Transfer (EFT) Authorization Form completed by an individual investor setting up automatic monthly contributions from a personal checking account into a Fidelity brokerage account. The form includes full account holder details, bank routing and account numbers, transfer amount and frequency, and an authorized signature with date.
Information used to fill out the document:
- Account Holder Name: Michael R. Thompson
- Fidelity Account Number: Z40-4892
- Fidelity Account Type: Individual Brokerage Account
- Address: 742 Evergreen Terrace, Portland, OR 97201
- Phone Number: (503) 555-0174
- Email Address: [email protected]
- Bank Name: Wells Fargo Bank
- Bank Account Type: Checking
- Bank Routing Number (ABA): 121042882
- Bank Account Number: 0074839201
- Transfer Amount: $500.00
- Transfer Frequency: Monthly
- Transfer Day of Month: 15th
- Start Date: 02/15/2026
- Purpose of Transfer: Automatic investment contribution
- Signature: Michael R. Thompson
- Date Signed: 01/20/2026
What this filled form sample shows:
- Correctly filled Fidelity account number and account type for an individual brokerage account
- Accurate bank routing (ABA) number and bank account number for a Wells Fargo checking account
- Clearly specified transfer amount of $500.00 with monthly frequency on the 15th of each month
- Properly defined start date of 02/15/2026 for the first automatic transfer
- Complete personal contact information including address, phone, and email
- Valid authorized signature and date confirming EFT authorization
Form specifications and details:
| Use Case: | Recurring automatic monthly investment contribution to a Fidelity brokerage account |
| Transfer Direction: | Bank to Fidelity (Pull from external bank account) |
| Account Holder Type: | Individual investor |
| Bank Institution: | Wells Fargo Bank |
| Fidelity Account Type: | Individual Brokerage Account |
| Transfer Frequency: | Monthly |
| Transfer Amount: | $500.00 per month |
| Form Purpose: | Authorize Fidelity to electronically debit a personal checking account for recurring investment contributions |
| Applicable Regulation: | ACH (Automated Clearing House) Network Rules |
| Form Version: | Fidelity EFT Authorization Form (2025–2026) |
Created: February 25, 2026 06:04 AM
