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St. Mark’s Anglican Church

P.O. Box 21425, 203 Logy Bay Road St. John’s, NF A1A 5G6 Rector: The Rev. Dr. G. Wayne Short

(709) 726-3213

Pre-Authorized Giving Authorization Form (VISA)

______________________________________ Parishioner Name(s) _________________________________________ VISA Card Number

______________ Expiry Date

I/We (the above mentioned parishioners) authorize the above named church to charge my/our VISA Card indicated above, in the amount of $

once per month (approximately on the fifteenth of

each month) beginning on ______________ until cancelled. This is for givings in respect of my/our annual offerings. Each donation shall be the same as if I/we had personally presented my/our card authorizing St. Mark’s Church to charge the amount to my/our card.

I/We will notify the St. Mark's Church Office promptly in writing if I/we cease to use the card, or if there is a change of expiry date, or if there is any change in the amount. This authorization may be cancelled at any time upon written notice by me/us to St. Mark's Church. I/We are all the persons who are required to sign on the above card. I/We have received a signed copy of this authorization form. ______________ Envelope Number

________________________________________ _______________________________________ Date

Parishioner Signature


Parishioner Signature