Secure Auto-Bank Draft Authorization
for Recurring Donation
Please provide the information requested below for the bank account you are authorizing ACT Intl to use for this recurring donation.
Name of Ministry or Ministry Staff Person you are supporting
Donor First Name
Last name
Donor Address 1
Address 2
City
State
Zip
Donor Email address
Phone Number
Bank Name
Routing Number
Account Number
Type of Account
Checking
Savings
Which day would you like the withdrawal to occur? (please choose one)
On the 5th (first business day following if a weekend or bank holiday)
On the 20th
(first business day following if a weekend or bank holiday)
Amount of donation USD
Enter comments or questions here
I understand that by submitting this request that I am authorizing Artists in Christian Testimony Intl to make automatic bank draft donations to the ministry I have chosen to support.
PLEASE CHECK THIS TO CONFIRM
Contact Information