Register for Pre-Authorized Withdrawal

Street, City, Prov, Postal Code
Please debit from my (our) account this amount on the first banking day on or after the 20th of each month commencing the month following the date of this form. Please allocate the funds to the following:
To allow time for processing of changes, I (we) will notify St. Anthony’s Parish of any changes in the account information or the termination of this authorization prior to the 10th day of any month.