Print, complete, and return to church office St. Paul’s United Methodist Church
201 S. Monroe St Monroe MI 48161
(734) 242-3000 /email@example.com DIRECT DEBIT AUTHORIZATION AGREEMENT
• 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
New Account Change Deduction or Offering Allotment Cancel Agreement
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.
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.