Online ACH Donation – Shelter from the Storm Ministries

General Information

Your Name

First

Last

Date / Time

Date

Time

Personal or Business Account?

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Banking & Donation Information

Financial Institution Name

Routing Number (9 digits)

Account Number

Checking or Savings Account? (allow 2 weeks for us to verify account & process your donation)

One time or recurring donation?-Choose One

This authorization will remain in effect until it is terminated and instructions changing the payment are received. Revocation may be orally by calling 608-478-4465 or by emailing cathy.redders@sftsm.org. Notification must be at least 14 business days prior to the scheduled transfer. Please retain a hard or electronic copy of this agreement for your records.

Do not proceed if you do not agree

One your debit

Authorization-Type first and last name in below box to agree SFTSM to electronically debit your account.

General Information

Banking & Donation Information

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