Print this page   Close this window

Mt Carmel Catholic Church

Automatic Draft Authorization

Please print (see below for directions) and fill out this draft authorization, and return it (with a voided check) to our office.

Thank you!

Our Lady of Mount Carmel Catholic Church


I, ___________________________________________________________, hereby authorize The Bank of Saint Francisville to

draft my account at (name of bank) __________________________________________________________ to

make deposits to Our Lady of Mount Carmel Catholic Church for purposes of tithing.

The routing number of the bank is _____________________________________________ and my account

number is ________________________________________________________.

Please draft according to the following schedule:

Amount $____________________________

_______Monthly Day of Month ________________________________

_______Biweekly Day of Week _________________________________

Specific Dates Dates _________________________________________

Please begin drafting on ______________________________________________________.

This authorization is valid and will continue until I revoke this "Authorization to Draft” in


____________________________________________________ _________________________

Signature Date

Received by:

____________________________________________________ _________________________

Church Official Signature Date

Please attach a voided check.