Automatic Bank Transfer (ABT) Update

Work Entry

Authorization to CHANGE an Existing Agreement

I am authorizing Legacy Christian Church to

Change My Existing ABT Agreement (Amount and/or Frequency).

First Name

Last Name

Address

Mobile Number

Home Campus

Please debit my (our) account in the amount of

I authorize Legacy Christian Church to debit this amount monthly on the

15th 30th 15th & 30th

Effective Date of Change

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.)

/ /

This authority is to remain in full force and effect until Legacy Christian Church has received written notification from me (or either of us) of its termination in such time and manner to afford Legacy Christian Church and my Financial Institution a reasonable opportunity to act on it.

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

Submit