Authorization for Automatic Payment Monthly Contribution This form is for ongoing contributions and should be filled out by parishioners who plan to donate weekly, monthly, etc. It will be found on the GIVE page. I authorize the following Parish and financial institution named here to initiate entries to my checking/savings account.(Required)Mary of the Immaculate ConceptionSaint BonifaceSaint JamesSaints Peter & PaulPlease select the parish you wish to make monthly contributions to. The authority will remain in effect until I notify my parish in writing to change or cancel my ongoing contribution to afford the financial institution a reasonable opportunity to act. I can stop payment of any entry by notifying my bank three (3) days before my account is charged. I can have the amount of an erroneous charge immediately credited to my account up to fifteen (15) days following the issuance of my bank statement or sixty (60) days after posting, whichever occurs first. I understand that it is my responsibility to give advance notice to my parish of any changes to my account, closing of my account, or change to a different institution.Name First Last Envelope Number Total Contribution Amount in Dollars Please enter the dollar amount you would like to contribute monthly to your selected parish.Account Type Checking Account (upload voided check) Savings Account (upload deposit slip) Upload FileMax. file size: 60 MB.Consent By checking this box, I agree to make monthly contributions to my selected parish until otherwise notified.Date Month Day Year Please write in todays date. Δ
