MTM Automatic EFT Donation Permission Form
Please fill out the form below to begin your monthly contributions.
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YOUR INFORMATION
First Name* |
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| Last Name* |
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| Address 1 |
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| Address 2 |
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| City |
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| State |
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| Zipcode |
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| Phone Number |
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| Email |
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Financial Information
Please fill out the information below
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| Monthly Contribution* |
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Please enter the amount in the box that you would
like to donate each month to More Than Music, Inc.
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Which day of the month would you like the donation
to be drafted?* |
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Number Only i.e. 1, 2, 3, 15, 30, etc.
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| Bank Name* |
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| Routing Number* |
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| Account Number* |
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DIGITAL SIGNATURE - By Entering your name in this
box, it is a signature agreement that you have
authorized More Than Music. Inc to draft the
"stated amount" on the "stated day" of each month.* |
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You may cancel at anytime by simply contacting us:
Phone: Kaitlin Odil, 720-284-9851
Email: kaitlinodil@yahoo.com
Mail: More Than Music, Inc. PO Box 181524 Denver, CO 80218
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| Image Verification |
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