Sustained Giving Form

You can share in our vision of spreading God's Word throughout the world through the work of Daystar missionaries. When you participate in ACH (Authorized Clearing House ) giving, your donation will be transferred conveniently from your checking or savings account, as designated below, directly to Daystar Baptist Missions, Inc. All donations are tax deductible and donors will receive a tax deductible receipt. All donations provided to Daystar Baptist Missions, Inc. originating as ACH transactions comply with U.S. law.

Donor Information

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

E-mail Address *

Bank Account Information

Bank Name *

Bank City *

Bank State *

Withdrawal Amount *

This Gift Is: *

A One Time Gift

Recurring Monthly Gift

For a one time gift select date for withdrawal. For recurring gifts please deduct the indicated amount every month on *

The 1st	The 7th
The 15th	The 21st

May we send your monthly receipt by e-mail? *

Yes

No

Designation *

* Other: Please Designate

Routing Number (9 Digits) *

Bank Account Number *

This Account Is A: *

Checking Account

Savings Account

Signature and Authorization

Signature (please type your first and last name)- I understand that by typing my name and submitting this form I am authorizing Daystar Baptist Missions, Inc. to initiate electronic debit/credit transactions from the account listed above. If the date you chose for the transaction is too close to the time we received this notice it will begin the following month. This authorization will remain in effect until Daystar Baptist Missions, Inc. has received written notification from me of its termination in sufficient time to reasonably act on it.

First Name *

Last Name: *

Date *