Automatic Monthly Giving Form
Automatic Monthly Giving Form If you would like to have an ongoing donation automatically withdrawn from your checking or savings account on or shortly after the 6th of each month, please complete the following:
Rockland Community Church Church Authorization Agreement for Direct Payment I/we hereby authorize Rockland Community Church to initiate debit entries to my/our account indicated at the bank named below: Checking or
Savings
Amount $_______________/monthly Bank Name:___________________________ Bank State: ______ Transit/ABA No. _____________________ Account No. ________________________ Or attach a voided check to this form This authority is to remain in full force and effect until Rockland Community Church and your bank have received written notification from me/us of its termination in such time and in such manner as to afford Rockland Community Church and your bank a reasonable opportunity to act on it. Name(s):________________________________________________________________________ Date: _____-_______-_________
Signature:____________________________________________________ Signature:____________________________________________________ Please print this page, complete it and return it to Rockland Community Church ATTN: Finance Manager.
Rockland Community Church Church Authorization Agreement for Direct Payment I/we hereby authorize Rockland Community Church to initiate debit entries to my/our account indicated at the bank named below: Checking or
Savings
Amount $_______________/monthly Bank Name:___________________________ Bank State: ______ Transit/ABA No. _____________________ Account No. ________________________ Or attach a voided check to this form This authority is to remain in full force and effect until Rockland Community Church and your bank have received written notification from me/us of its termination in such time and in such manner as to afford Rockland Community Church and your bank a reasonable opportunity to act on it. Name(s):________________________________________________________________________ Date: _____-_______-_________
Signature:____________________________________________________ Signature:____________________________________________________ Please print this page, complete it and return it to Rockland Community Church ATTN: Finance Manager.
