R E C L A I M E D   M I N I S T R I E S,   I N C.

 

Electronic Fund Transfer Gift Form

Follow these steps to give to Reclaimed Ministries, Inc. through Electronic Funds Transfer (EFT)

1. PRINT OUT THIS PAGE  

2. (a) Denote whether this is a monthly gift   (b) you are changing your monthly amount  (c) this is a one time gift

3. Write in the amount that you are pledging to Reclaimed Ministries, Inc. through (EFT)

4. Fill in your full name and address and the name and address of your financial institution

5. Mail the Bank Draft Authorization Form to:

Reclaimed Ministries, Inc.

6698 Roosevelt Ave.
Bath, New York 14810
For additional information telephone (607) 664-1373

 

Your Name____________________________________________________________________
 
Address_______________________________________________________________________
 
City________________________________State___________________Zip_________________
 
Tel____(________)_________________________________

BANK DRAFT AUTHORIZATION FORM

I hereby authorize Reclaimed Ministries, Inc. and the financial institution named below to draft my bank account  each month in the amount shown below (this also includes my authorization for Reclaimed Ministries, Inc. to reverse any charges made in error). This authority will remain in effect until I give written notice to cancel or change it. I further agree that Reclaimed Ministries, Inc. shall neither incur nor assume any  liability and shall be held harmless against any and all claims that may arise.

(please check one)

MONTHLY GIFT _____

CHANGE MY MONTHLY AMOUNT _____

ONE TIME GIFT ONLY _____

(All gifts to Reclaimed Ministries, Inc. will be drafted from your account on the 15th of each month)

 

GIFT AMOUNT: $_______________________

 

Name and address of financial institution:

Bank Name_____________________________________________________________________
 
Address________________________________________________________________________
 
City__________________________________State__________________Zip_________________
 
Tel:__(________)___________________________________

 

* PLEASE INCLUDE A VOIDED CHECK (IF DRAFTING FROM A SAVINGS ACCOUNT A DEPOSIT SLIP) WITH THIS        AUTHORIZATION

 

SIGNATURE ____________________________________________ DATE ________________________