LHI E-Checking Authorization

Secure Living Hope International, Inc. eCheck Authorization Form
Full Name *

First Name Last Name
Short description of how you wish for your gift to be designated: *
Name as it appears on your checking account *
Bank name *
Bank's ABA routing number *
Your bank account number *
Bank account type *

Personal Savings Personal Checking Business Checking
I authorize Living Hope International, Inc. to charge my bank account when requested by me. *

I agree
For recurring monthly gifts please answer the following questions.
Monthly recurring gift
I authorize Living Hope International, Inc. to charge my bank account on a monthly basis starting on:

Month Day Year Date Picker Icon
This payment authorization is valid and to remain in effect unless I notify Living Hope International, Inc. of its cancellation by sending written notice to accounting@lovehopemercy.org

Your mailing address *