3

 

By signing this form, you authorize the Community Foundation of West Georgia (CFWG) to automatically withdraw $20.00 dollars from the specified bank account on a monthly basis until you discontinue the deduction or until a period of twenty years has elapsed, whichever comes first. If sufficient funds are not available at the time the withdrawal is attempted, you authorize CFWG to submit the withdrawal for payment a second time and agree that all associated bank overdraft or other bank fees are solely your responsibility. You may discontinue your participation in the 20 for 20 program at any time. To discontinue your participation in the program and stop the monthly withdrawals you must notify CFWG in writing. Please note that it may take up to 30 days after the CFWG receives your written request to stop the automatic withdrawals.