St. Ignatius Loyola Catholic Church
2300 Burnhamthorpe Road West, Mississauga, ON  L5L 3T6
Tel. (905) 820-1444    •     Fax (905) 820-6879

Pre-Authorized Giving Plan Authorization Form
  • Fill in the form using your keyboard, then print the page
  • Sign and date the form
  • Bring it (or fax it) to the Church, along with a cheque marked "VOID"
Name(s):
Address:
City:
Province: Postal Code:  
Phone #:
Parish Offertory Envelope #:
Name of Financial Institution:
Address:
City:
Province: Postal Code:  
Bank Account #
Amount of Monthly Offertory: $ .00
I hereby authorize the pastor of St. Ignatius Loyola parish to debit my/our account on or about the 20th day of each month the amount indicated above as my/our offertory contribution.  Attached is a blank cheque marked "VOID".

For joint accounts where your bank requires both signatures, please ensure that both parties sign below.  This authorization may be cancelled at any time upon written notice.
Signature(s):      
Date: