Authorization Draft Agreement

Date*
MM slash DD slash YYYY
Authorization Draft Agreement
2023-2024 School Year
I (we) hereby authorize Family Education Resource Ministries/AKA Grace Academy to initiate debit entries and initiate, if necessary, credit entries and adjustments for any debit entries in error, due to my (our) checking account indicated below and the depository (Bank) named to debit and/or credit the same account. This authorization is to remain in full effect for 30 days after Family Education Resource Ministries/AKA Grace Academy has received written notification from me (or either of us) of its termination.
Financial Institution/Bank Name*
Bank Account Type*
- Checking
- Savings
Transit/ABA No.*
Email*
Enter Email Confirm Email
Account Number*
Monthly Draft Amount*
Monthly Draft Date*
Day monthly draft occurs.
- 1st of month or next banking day thereafter
- 15th of month or next banking day thereafter
Date of FIRST draft*
MM slash DD slash YYYY
Date of LAST draft*
MM slash DD slash YYYY
Name of Account Holder*
First Last
Phone number of Account Holder*
We require 14 days to make draft changes but will try to accommodate changes with shorter notice if possible.
Date*
MM slash DD slash YYYY
Signature*
Date
MM slash DD slash YYYY
Signature #2