St. John's Lutheran Church

Forms

Authorization Agreement for Pre-authorized Donations

St. John's Lutheran Church - Le Mars, Iowa

I (we) hereby authorized St. John's Lutheran Church, herinafter called St. John's to initiate debit entries to my (our) account (if possible attach an image of a check or supply bank routing #) indicated below and the donor named below, herinafter calle DONOR, to debit same to such account.

Automated Giving Form

Name

City

State

Zip

Transit/ABA No.

Account

Checking or Savings Account #

Frequency of Contribution

Date of First Contribution

Please enter a $ amount next to which funds you wish to donate.

General Fund

Endowment Fund

Capital Fund

Total Giving

I (we) authorize St. John's and Primebank to automatically withdraw offerings/donations from my account.

Yes No

The authority will remain in effect until I (we) provide reasonable notification (12 noon - 2 working days previous to transaction date) to terminate the authorization.

Yes No

Name & Date

Optional Attachments

Maximum File Sizes: 4 MB each

File 1
File 2
File 3