THE “OUR HOME ~ OUR FAMILY ~ OUR FUTURE” AUTOMATIC CONTRIBUTION SYSTEM
We are pleased to be able to offer you the opportunity How the ACS Program works:
to have your commitment payment made You authorize a monthly or weekly deduction from
automatically from your checking account. your checking account by completing the
“Authorization Agreement “provided below. Then
The Automatic Contribution System (ACS) will relax, your pledge payment will be automatically
help you in several ways: debited from your account on the first business day of
each month or the last business day of each week.
It saves time. Proof of your payment will appear on your bank
No checks to write. statement.
No envelopes to keep track of.
No postage expenses. The authority you give to charge your account will
Helps you to honor your commitment in a remain in effect until your pledge is paid or until you
convenient and timely manner – even when notify us in writing to terminate the authorization.
you are on vacation or out of town.
The ACS Program is dependable, flexible, convenient,
It is easy to sign up for and easy to cancel. confidential, and easy. To take advantage of the
It will provide you with a record of your program, complete the following authorization form
contribution on your bank statement. and return it to us along with a voided check or
savings deposit/form and the envelopes you will no
AUTHORIZATION AGREEMENT FOR DIRECT DEBIT
I (we) authorize St. Ann Catholic Church (Tax ID # 62-0639393) and Regions Bank, to
initiate credit entries and adjustments for any debit made in error to the CHECKING
account indicated below and the depository named below, to debit and/or credit the
same to such account for the purpose of making payment on my (our) “Our Home ~ Our
Family ~ Our Future” pledge.
DEPOSITORY BANK ___________________________________________________________
ROUTING # __________________________________________________________________
(The number between these symbols |: |: on the bottom left of your check)
ACCOUNT # __________________________________________________________________
MONTHLY DEBITED AMOUNT_______ OR WEEKLY DEBITED AMOUNT _______
This authorization is to remain in full force and effect until my pledge commitment is
fulfilled or until St. Ann Catholic Church has received written notification from me (or
either of us) of its termination in such time and in such manner as to afford St. Ann
Catholic Church and Depository Bank a reasonable opportunity to act upon it.
NAME(S) __________________________________ ENVELOPE # ________ Date________
Include ______ Do not include _____ on the parish email list
SIGNED _______________________________ ______________________________
PLEASE ATTACH A VOIDED CHECK OR DEPOSIT SLIP