I authorize United Ways of Alabama to initiate electronic credit entries to my account. I understand that, if necessary, an adjusting debit entry may be made to correct an error. I also authorize the financial institution below to credit and/or debit my account for the correcting entries. I duly certify that I am an authorized signer of said account and have the right to enter into this agreement. This authority will remain in full force and effect until such time as United Ways of Alabama has received written notification from me or until written notification of termination by either party has been provided. Checking Account Savings Account FINANCIAL INSTITUTION FINANCIAL INSTITUTION CITY & STATE TRANSIT ROUTING NUMBER ACCOUNT NUMBER INFORMATION |: | | | | | | | | | | |: NOTE: Only 9 digits in Routing Numbers SIGNATURE NAME OF AUTHORIZED SIGNER COMPANY NAME COMPANY ADDRESS ATTACH A VOIDED CHECK HERE
I authorize United Ways of Alabama to initiate electronic credit entries to my account. I understand that, if necessary, an adjusting debit entry may be made to correct an error. I also authorize the financial institution below to credit and/or debit my account for the correcting entries. I duly certify that I am an authorized signer of said account and have the right to enter into this agreement. This authority will remain in full force and effect until such time as United Ways of Alabama has received written notification from me or until written notification of termination by either party has been provided. Checking Account Savings Account FINANCIAL INSTITUTION FINANCIAL INSTITUTION CITY & STATE TRANSIT ROUTING NUMBER ACCOUNT NUMBER INFORMATION |: | | | | | | | | | | |: NOTE: Only 9 digits in Routing Numbers SIGNATURE NAME OF AUTHORIZED SIGNER COMPANY NAME COMPANY ADDRESS ATTACH A VOIDED CHECK HERE