“The Children’s Organ Transplant Association (COTA) empowered those around us to do something to help during this time of great need for our family. In the midst of putting our lives on hold and relocating more than 1,100 miles away from our home for Jude to receive top-notch medical care, COTA made sure everything was Read More

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Liver Transplant Recipient

Direct Deposit Application

Direct Deposit Agreement

  • Please complete this form to setup an account for direct deposit of funds. Please note, funding may be delayed until verification of direct deposit setup is complete.
    I hereby authorize the Children's Organ Transplant Association to initiate automatic deposits to my account at the financial institutions named in this section. I also authorize the Children's Organ Transplant Association to initiate withdraws from this account in the event that a credit entry is made in error. Further, I agree not to hold the Children's Organ Transplant Association responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement will remain in effect until the Children's Organ Transplant Association receives written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form to the Children's Organ Transplant Association.