The United Parish of Auburndale
64 Hancock Street
Auburndale, MA 02466
Recurring Payment Authorization Form
Schedule your payment to be automatically deducted from your checking or savings account.
Just complete and sign this form to get started!
Recurring Payments Will Make Your Life Easier:
- It’s convenient (saving you time, paper and postage)
- Your donation is consistent(even if you’re out of town), helping the church remain consistent.
Here’s How Recurring Donations Work:
You authorize regularly scheduled charges to your checking or savings account. You will be charged the amount indicated below each billing period. A receipt for each payment will be emailed to you and the charge will appear on your bank statement. You agree that no prior-notification will be provided unless the date or amount changes. Donations will appear on your personal, private quarterly and year-end reports for tax purposes.
Please complete the information below, print, and deliver to the United Parish of Auburndale. If funds are to be drawn from a Checking Account, a copy of a voided check must accompany this form.
I ____________________________ authorize The United Parish of Auburndale to charge my bank account
indicated below on the ________ of each [insert frequency] as a charitable donation.
(day or date)
Billing Address ____________________________ Phone# ________________________
City, State, Zip ____________________________ Email ________________________
|Account Type: Checking Savings
Name on Acct _______________________________
Bank Name _______________________________
Account Number _______________________________
Bank Routing # _______________________________
Bank City/State _______________________________
I understand that this authorization will remain in effect until I cancel it in writing.