Pre-Authorized Giving Donor Card |
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| Name of Contributor: | |
| I hereby request and authorize the Anglican Diocese of Toronto to withdraw from my account each month the amount of $________ as a contribution by me to my local church and in the amount of $________ to FaithWorks. | |
| For joint accounts, both signatures MUST appear on this form. This authorization may be cancelled at any time upon written notice. | |
| Name and Address of Local Church: The Church of St. Jude (Wexford)
10 Howarth Avenue Scarborough, ON, M1R 1H4 |
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| If you would like your parish to record designated amounts from your PAG for specific projects, please indicate projects and amounts here: | |
Project |
$ Amount |
| Bank Account Number: | |
| Type of Account: | |
| Branch Number: | |
| Name and address of Financial Institution: __________________________________________ __________________________________________ __________________________________________ |
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| To ensure accuracy, a simple cheque marked "void" must accompany this card to be placed in an envelope for the offering plate at your parish. | |
-- OR -- |
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| I wish to make my Pre-Authorized Gift by: | |
| O Visa | O Mastercard |
| Card No.:
__________________________________________ Expires: __________________________________________ |
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| Date: __________________________________________ Signature of Contributor(s): __________________________________________ __________________________________________ |
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