ACH Authorization

PAYMENT AUTHORIZATION

AUTHORIZE RECURRING CONTRIBUTIONS

ቀጻሊ ክፍሊት ንምፍቃድ ቅጥዒ

Use this form to authorize the Eritrean-American Debes Association of Georgia to debit your checking or savings account for approved membership contributions. Please enter your banking information carefully and confirm your authorization before submitting.

AUTHORIZE RECURRING CONTRIBUTIONS

ቀጻሊ ክፍሊት ንምፍቃድ ቅጥዒ
Use this form to authorize the Eritrean-American Debes Association of Georgia to debit your checking or savings account for approved membership contributions. Please enter your banking information carefully and confirm your authorization before submitting.

Authorization Information

Full Name *

Email Address *

Phone Number *

Paying For

If Other, Enter Name

Bank Information

Date

Short Form Note

This authorization remains active until written notice of termination is received by the Eritrean-American Debes Association of Georgia with reasonable time to process the request.

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