Automatic Bank Transfer (ABT) Cancellation Request

Work Entry

Authorization to CANCEL an Existing Agreement

I am authorizing Legacy Christian Church to

Cancel my existing ABT Agreement.

**Please use the ABT Update Form to CHANGE an existing agreement!**

First Name

Last Name

Mobile Number

Effective Date of Cancellation

Please share the reason you are cancelling your ABT.

Electronic Signature

I understand that typing my full name in the "Electronic Signature" field above is the legal equivalent of submitting a document signed by hand, and indicates that I am providing written notification to terminate my original Authorization Agreement for Automatic Bank Transfer.

Date of Birth (This is required for verification purposes.)

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**Clicking the "Submit" button below confirms this request.**

Submit