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
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:
* PLEASE INCLUDE A VOIDED CHECK (IF DRAFTING FROM A SAVINGS ACCOUNT A DEPOSIT SLIP) WITH THIS AUTHORIZATION
SIGNATURE ____________________________________________ DATE ________________________