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ACH Authoization Form

- Giving

Thank you for wanting to support our parish on a regular basis. The easiest way to sign up for Direct Deposit is through this online form. If you prefer, you can download a PDF version of the form by clicking here and mail with a voided check to Holy Cross Parish, 3012 Jackson Street, Sioux City, IA 51104.
ACH Authorization Online Form
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- Type of Authorization REQUIRED Please fill out this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address: REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Envelope # Please enter valid data.
- Frequency REQUIRED Please fill out this field.
- Amount REQUIRED Please fill out this field. Please enter valid data.
- Beginning Date of ACH Change Please enter valid data.
- Banking Information
  
  Name of Bank REQUIRED Please fill out this field. Please enter valid data.
  
  Bank Branch Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Bank's Routing Number REQUIRED Please fill out this field. Please enter valid data.
  
  Account Number REQUIRED Please fill out this field. Please enter valid data.
  
  Account Type REQUIRED Please fill out this field.
- Authorization
  
  I authorize Holy Cross Parish to process debit entries from my account. I understand that this authority will remain in effect until I terminate the authorization by completing another ACH Form.
  
  I Agree Please select this field.
- Initials REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter valid data.
- Comments
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Holy Cross Parish

SIOUX CITY, IA

ACH Authoization Form

ACH Authorization Online Form

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