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    Monthly Pledge Form

    Uploaded by

    Anonymous HufvSNsYno
    This document is a monthly donation form for automatic electronic bank withdrawals from Masjid Sabireen. It requests the donor's contact information as well as bank account information to set up recurring monthly donations of $30, $50, $75, $100, $250, $500 or $1000, or another specified amount. The donor authorizes Masjid Sabireen to debit the specified amount from their bank account each month until revoked.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Monthly Pledge Form

    Uploaded by

    Anonymous HufvSNsYno
    25 views1 page
    This document is a monthly donation form for automatic electronic bank withdrawals from Masjid Sabireen. It requests the donor's contact information as well as bank account information to set up recurring monthly donations of $30, $50, $75, $100, $250, $500 or $1000, or another specified amount. The donor authorizes Masjid Sabireen to debit the specified amount from their bank account each month until revoked.

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    This document is a monthly donation form for automatic electronic bank withdrawals from Masjid Sabireen. It requests the donor's contact information as well as bank account information to set up recurring monthly donations of $30, $50, $75, $100, $250, $500 or $1000, or another specified amount. The donor authorizes Masjid Sabireen to debit the specified amount from their bank account each month until revoked.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    25 views1 page

    Monthly Pledge Form

    Uploaded by

    Anonymous HufvSNsYno
    This document is a monthly donation form for automatic electronic bank withdrawals from Masjid Sabireen. It requests the donor's contact information as well as bank account information to set up recurring monthly donations of $30, $50, $75, $100, $250, $500 or $1000, or another specified amount. The donor authorizes Masjid Sabireen to debit the specified amount from their bank account each month until revoked.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    MONTH TO MONTH DONATION FORM

    Monthly Automatic Electronic Bank Withdrawals

    Donors Full Name ( First/Middle/Last): ___________________________________________________


    Address :__________________________________________

    Apt/Unit #: ____________________

    City: ___________________________

    Zip: __________________________

    State:____________

    Primary Phone #: ______________________

    Alternate Phone #: __________________________

    Email address (For Islamic centers use only): ______________________________________________


    Name of your Bank (Full Name Please): ___________________________________________________
    Account Number (Please Enter Full Number): ______________________________________________

    I, hereby authorize Masjid Sabireen to initiate debit entries to my account number listed above, and I authorize my
    bank to debit the same to such account. Each such debit shall be made on the first day of each month in the amount
    listed here below:
    (Please Circle One)

    $30

    $50

    $75

    $100 $250 $500 $1000

    Other Amount (Please Specify): $__________

    This authority is to remain in effect until I revoke the agreement as hereinafter provided. I understand that
    I may revoke this agreement at any time by notifying Masjid Sabireen (we appreciate a month in advance
    notice.) Jazak Allah Khair.
    PLEASE ATTACH A VOID CHECK TO THIS FORM

    _______________________________________________

    ________________________

    Signature of the donor

    Date

    www.masjidsabireen.com
    Phone: (909) 865-7833

    sabireenmasjid@gmail.com
    Fax: (909) 865-7823

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