PLEASE FILL ONE AUTHORIZATION FOR
EACH MINISTRY WORKER
Name of Missionary or
Ministry Work:__________________________________________
Authorization Agreement
for Preauthorized Debits
Ministry Name: Hands Across
the Waters
I hereby authorize Hands
Across the Waters to initiate debit entries to my Checking or
Savings account as indicated below and the Financial Institution
named below to debit the same to my account.
PLEASE PRINT
Your Financial Institution
Name: ____________________________________
ABA / Routing Number:
___________________________________________
Checking or Savings Account
Number (please circle
one and attach voided check)
Monthly Amount:
__________
Date for funds to be
transferred: 2nd of each month
This authority is to remain
in full force and effect until Hands Across the Waters has received
written notification from me of its termination in such time and in
such manner as to afford Hands Across the Waters and Evangelical
Christian Credit Union a reasonable opportunity to act on it.
Authorized Signature:
____________________________________ Date: ___________
Please print name:
_________________________________________