ContractAuthorization Agreement for Automatic Withdrawal of Funds • May 24th, 2007
Contract Type FiledMay 24th, 2007AUTHORIZATION AGREEMENT FOR AUTOMATIC WITHDRAWAL OF FUNDS Chatham-Summit Friends Meeting ES6608 Last Name First Name Address City State Zip Meeting Fund Dollar Amount Frequency (check one for each church fund and include the effective date)❑ Operating Fund $ ❑ Weekly – debited on Monday, beginning / (dd/mm)❑ Bi-monthly – debited on the 1st and 15th of each month, beginning in (month)❑ Monthly – debited on the 1st of every month, beginning in (month)❑ Quarterly – debited on the 1st of every third month beginning in (month) ❑ Building ❑ Weekly – debited on Monday, beginning / (dd/mm)Renovation Fund $ ❑ Bi-monthly – debited on the 1st and 15th of each month, beginning in (month)❑ Monthly – debited on the 1st of every month, beginning in (month)❑ Quarterly – debited on the 1st of every third month beginning in (month) ONE-TIME CONTRIBUTION (credit card option only) $ Date to be transferred / / CHECKING / SAVINGS Please debit my contribution from my (check one): Routing Number: Valid Routi