St. Augustine's Episcopal - Pledge Online - St. Augustine's Episcopal Church

Direct Withdrawal

You can sign up for direct withdrawal by filling out our form online, or, if you prefer, printing the form and mailing it to Jamee Meisner, 3412 Haring Road, Metairie, LA 70006.

click here to print & mail your form

AUTHORIZATION AGREEMENT FOR DIRECT WITHDRAWAL (Electric Funds Transfer - EFT)

I/we hereby authorize St. Augustine's Episcopal Church, hereinafter called St. Augustine's, to initiate debit entries to my/our

* Indicates required field

select one *

Checking Saving

The depository (bank or other financial institution) named below, to debit the same to such account as follows:

Amount of $ *

to be drafted on *

the 3rd the 17th the 3rd and 17th

of the month (select one).

For Checking or Saving Account withdrawals, please fill out the following:

Financial institution *

Name *

First

Last

Zip code *

City *

State *

Routing number *

account number *

This authority is to remain in full force and effect until St. Augustine's has received written notification from me (or either of us) of its termination in such time and in such manner as to afford St. Augustine's and the depository a reasonable opportunity to act on it.

Submit