First United Methodist Church

Automatic Giving

Return this form for Authorization for Direct Payment from your financial institution (bank account)

I / We hereby authorized First United Methodist Church to initiate debit (withdrawal) entries and if necessary debit correction and adjustment entries to my / our account at the financial institution designated below:

Type of Account (check one) � Checking � Savings

Name of Financial Institution_______________________________________________

Address________________________________________________________________

Routing and Transit Number___________________ Account Number_____________

Frequency of Direct Payment Withdrawal (check one)

� Weekly � Monthly

Day of week_______________ Day of Month_______________

Amount to be withdrawn $_____________________ Begin Date______________

Please distribute my contribution as follows:

Operating $__________ Benevolence $__________ Improvement $__________

Other________________ $______________

Signature_________________________________________ Date__________________

Please attach a voided check or Financial Institution Account Verification Letter.

Any account that does not have the required funds available will be charged a $25.00 NSF Fee.

This authority will remain in full force and effect until you give the Church written notification of termination, with allowance for reasonable time for the Church to act upon the notification.

First United Methodist Church ● 510 West Maple Street ● Clyde, OH 43410 ● 419-547-0734