EFT Change Form
Name
*
First Name
Last Name
Current Donation Amount
*
If this is for a church/organization, please enter that name below:
Email
*
example@example.com
I would like to change the amount of my donation to:
Start my new donation amount AFTER:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
If no date is selected, change will start with the next date donations are processed.
Change my bank account number from (last four digits):
Change my bank account number to:
Change my bank routing number to:
Your bank account information remains in a secure environment.
Cancel my participation in IM's automatic donation program after:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please verify that you are human
*
Other Comments or Questions:
Signature
*
Submit
Should be Empty: