BANK DRAFT FORM Name * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Member Authorization * New Authorization Change Contribution Date Change Financial Institution Account Change Contribution Amount Discontinue Electronic Giving Annual Contribution * Semi-Monthly (transfers on the 1st and 15th) Monthly If monthly, please choose the date to draft 1st 5th 15th 20th 25th 2nd Monday 4th Monday Account Information * Checking Account Savings Account Name of Financial Institution * Routing Numbers * Account Number * Authorization * I authorize First United Methodist Church - Lufkin and Vanco Services, LLC to process debit entries to my account. I have attached a voided check or savings deposit slip. This authority is to remain in full force and effect until FUMC has received written notification from me (or either of us) of its termination in such time and in such manner as to afford First United Methodist Church - Lufkin & Vanco a reasonable opportunity to act on it. Yes No Thank you for filling out First UMC - Lufkin’s ACH Form.
