Print, complete, and return to church office                                                                 St. Paul’s United Methodist Church
                          201 S. Monroe St Monroe MI 48161
                         (734) 242-3000 /
          •   Please type or print legibly in black ink
          •   Check the correct box to indicate whether this is a new application, change of deductionAmount/allotment,
               or a cancellation of deduction agreement.
          •   Attach a voided check to the completed application for validation of bank and account information.
          •   For security of your personal information, enclose in an envelope marked “Direct Debit Authorization”
               and place in offering pllate or deliver directly to the church office.
          •   Offering allotment for an existing account should be made by completing the following information and
               recording your name only and submitting as noted above.
         Current Expenses  _______________%
         Building Fund ___________________%      Check if you want 15% applied to missions
         Other __________________________%
         Total ___________________________%
            New Account                     Change Deduction or Offering Allotment                   Cancel Agreement

               Address:                                                                                                                    Social Security #:
               City:                                                                    State:                                                                            Zip:
               E-mail Address                                                                                                         Phone:

           I hereby authorize St. Paul’s United Methodist Church to debit my Checking Account or
           Savings Account   at the financial institution named below for payments* of church offering.  I
           acknowledge that the origination of ACH transactions to my account must comply with the provisions
           of U.S. law.  St. Paul’s United Methodist Church and I agree to abide by all applicable ACH operating rules.

            *Payments may be deducted on the 5th and/or 20th of each month as follows:
                - Deduct $_____________     monthly on the __________ day.
                - Deduct $_____________     biweekly on the 5th and 20th  day.

            Financial Institution:
            Bank Transit & Routing Number:                                                               Account Number:
            Name as it appears on the bank account
            Direct Deposit Payments will begin on:

           This agreement is to remain in full force and effect until St. Paul’s United Methodist Church has received
           written notification from me, or have received written notification from St. Paul’s United Methodist Church
           of its termination so as to afford the interested parties a reasonable time to act on it.