Haack Direct Deposit Form

Thanks for your support of Joe and Josie Haack as they prepare for their return to Columbus to plant the Grandview Heights congregation! To begin the process of automating your support from your checking account, complete the following steps. 1. 2. 3. 4. 5.

Complete the form below Attach a voided check Specify the amount you’d like to have withdrawn on a monthly basis Specify the length of time you’d like the money to be withdrawn Send the form to Grace Central Presbyterian Church

Joe and Josie Haack Planting Fund Grace Central Presbyterian 49 West Fifth Ave. Columbus, Ohio 43201 Grace Central will begin the process of withdrawing from your account on the first business day of the month following the receipt of this completed and signed form if the form arrives before the 20th day of month. You will receive a statement from Grace Central listing your donation amounts in January of the next year for your tax filing purposes. Cancellation and Change Policy If you want to cancel your withdrawals, please notify Grace Central in writing no later than 10 business days before the 1st of the month for which you want it cancelled. If you need to change to change your checking account information, please email Mike Donahoe ([email protected]) or mail us a voided check for the new account and a brief note of your request. Your request must arrive in our office no later than 10 business days before the 1st of the month for which you want it changed.

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Please specify the amount that you’d like to have withdrawn monthly from your account. $________ Please specify the term (1 year, 2 years, 3 years) for which you’d like have your support pledge with drawn from your account._________ I hereby authorize the above monthly ACH donation for Joe and Josie Haack’s Plant Fund until written notification from myself to discontinue such. I have read and understand the ACH cancellation policy written above. Signature: _____________________________________________

Date:___________________

Printed Name:__________________________________________ Address:_______________________________________________

Home Phone:_____________

City, State, Zip:_________________________________________

Work Phone:_____________