Bel Air United Methodist Church

 

Electronic Funds Transfer Application

                                                                                                                                                38103162727

 

Date

Envelope #

Phone #

 

Effective Date: ­___________________

q     New Authorization

q     Change Contribution Amount

q     Change Contribution Date

q     Change Financial Institution Account

q     Discontinue Electronic Giving

 

Name(s) of Member (Please Print)

 

Street  Address                                                            Email Address:

 

City

State

Zip

 

Regular Contribution

 

q     Weekly (Transferred on Mondays)

 

q     Semimonthly (Transferred on the 1st & 15th)

 

q     Monthly (Transferred on either the 1st or the 15th)

                              CIRCLE ONE:  1ST     15TH 

 

q     Quarterly (The 1st of the month beginning ____________)

 

 

General Fund                                  $____________

 

Building Fund                                 $____________

Total Contribution Amount          $____________

 

 

Annual Contributions

 

Easter Offering                              $____________

(Transferred April 1st)

 

Thanksgiving                                 $____________

(Transferred November 15th)

 

Christmas                                      $____________

(Transferred December 15th)

 

Other  ______________              $____________

 

Date of Transfer                            _____________

Please take my contribution directly from the account specified:

q     Checking Account (attach a voided check)

q     Savings Account (attach a savings deposit slip)

 

Routing #:

Routing number must start with 0, 1, 2, or 3, is 9 digits long, and is located at bottom of check between these symbols ›:›:

Account #:

I authorize Bel Air United Methodist Church and Vanco Services, LLC to process debit entries to my account.  I have attached a voided check or savings deposit slip.  This authority will remain in effect until I give reasonable notification to terminate this authorization.

 

Authorized signature on my account:                                                                           Date:

Please attach a voided check or savings deposit slip.

 

 

Print off, and return completed and signed form in a sealed envelope to William Groseclose, Bookkeeper at BAUMC.  If you wish to mail, send to Bookkeeper, BAUMC 21 Linwood Avenue, Bel Air, MD  21014.