Authorization Agreement for Electronic Contributions -St. Mary's, Cottonwood

St. Mary's Catholic Church
255 W. 4th St. S.
PO Box 228
Cottonwood, MN 56229
Phone: 507-423-5220

I (we) hereby authorize St. Mary's Catholic Church of Cottonwood, MN hereinafter called "Church" and the financial institution named below to initiate direct tithing (entries) from my account chosen below. This authority will remain in effect until I (or one of us) terminate it in writing. This will be done in such time as to afford the church and the financial institution a reasonable opportunity to act on it.

I (we) hereby authorize St. Mary's Catholic Church of Cottonwood, MN hereinafter called "Church" and the financial institution named below to initiate direct tithing (entries) from my account chosen below. This authority will remain in effect until I (or one of us) terminate it in writing. This will be done in such time as to afford the church and the financial institution a reasonable opportunity to act on it. AGREE
Account Holder Name (as shown on account) Account Holder Name (as shown on account) First Middle Last
Joint Account Holder Name (as shown on account) Joint Account Holder Name (as shown on account) First Middle Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Name of Financial Institution
Type of Account

Type of Account Checking Account Savings Account
Routing Number (lower left of check)
Account Number
Debit amount for My Sunday Offering (Debited monthly, semi-monthly, or both.) $ Dollars . Cents
Select Debit Date(s) for My Sunday Offering

Select Debit Date(s) for My Sunday Offering 15th of Each Month 30th/31st of Each Month Both Dates
Please begin my automated electronic payments on: Please begin my automated electronic payments on: / MM / DD YYYY
Type the letters you see in the image below.