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					    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
                                                          longer need!

         __________________________________________________________________
                          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________

         E-mail ___________________________________________________________

         Include ______                   Do not include _____ on the parish email list

         SIGNED _______________________________                 ______________________________
                            PLEASE ATTACH A VOIDED CHECK OR DEPOSIT SLIP

				
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posted:10/14/2011
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