And the Things You Have Heard Me Say in the Presence of Many Witnesses Entrust to Reliable

2 Timothy2:2

And the things you have heard me say in the presence of many witnesses entrust to reliable men who will also be qualified to teach others.

ACH Debit Form

For your convenience, this form will enable you to schedule your donation to222 MinistriesUSA to be automatically deducted from your checking or savings account. Please complete and sign this form to set up an electronic debit.

I, ______authorize 222 Ministries USA, Inc. to charge my bank

(full name)

account indicated below the amount of (i) $______every month on the first day of the month (ii) a one-time donation of $______.

Account Type: □ Personal Checking □ Personal Savings □ Business Checking □ Business Savings

Name on Account______

Account Number ______

Bank Routing Number______

Bank City/State______

Signature______Date______

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify 222 Ministries USA in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as indicated above. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that 222 Ministries USA may at its discretion attempt to process the charge again within 30 days. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.

PO Box 1926 Glendale, CA 91209 Tel: 818-550-1222