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Coulson, Scott & Dalia #20038

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Director of Street Level Ministries, Local and International operations targeting unreached people groups.

Change EFT/eCheck Donation bank information.

Please enter your name*
First Last
Staff name you are supporting*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Email Address
Phone Number
Bank Name
Frequency
- Checking Account
- Savings Account
Routing #
Account #
Retype Account #
Bank Account Agreement*
- I Agree
By selecting the "I Agree" checkbox below, I acknowledge that I have read, understand and agree to these Terms and Conditions and that this agreement constitutes a "writing signed by me" under any applicable law or regulation. I authorize Ripe for Harvest to initiate electronic funds transfers (debits) from my account at the financial institution listed above and to initiate deposits (credits) if necessary for any withdrawals made in error. This authority is to remain in full force and effect until Ripe for Harvest has received notification from me of its termination in such time as to afford Ripe for Harvest reasonable opportunity to act on it. All contributions to Ripe for Harvest are income tax-deductible and are made with the understanding that Cru has complete discretion and control over the use of all donated funds.
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Changes To Credit Card Information

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First Last
Staff name you are supporting*
First Last
Please select from the options below*
- Please change my billing address for my Credit Card donations.
- Please change my Credit Card number.
- Please, only change my Expiration Date on my existing credit card.
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Email Address
Phone Number
Old Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
New Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name on card:
New Credit Card Number
Please enter a number from 16 to 16.
Expiration Date:
MM slash DD slash YYYY
Security Number on back of new card:
Please enter a number from 3 to 3.
Change Expiration Date:
MM slash DD slash YYYY
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Changes To Credit Card donation

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First Last
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First Last
Please select from the options below*
- I would like to change the amount I am giving.
- Please discontinue my giving.
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Email Address
Phone Number
Current Donation
New Amount
Frequency
- One Time
- Monthly
- Quarterly
- Annually
Discontinue options*
- Immediately
- On this month:
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Email my tax-deductible receipts

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Staff name you are supporting*
First Last
Please select from the option(s) below*
- I/We would rather not receive paper mailed receipts.
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Email Address
Phone Number
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Update contact information

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First Last
Staff name you are supporting*
First Last
Please select items you would like to change*
- Mailing Address
- Email Address
- Phone Number
Old Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
New Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Old Email Address
Your New Email
Old Phone Number
New Phone Number
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Tax Receipt Request

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Please select from the options below*
- Send me receipt for donations
- Send me my Year-To-Date total
- Please mail my request(s) to the address above.
- Please, email may request(s) to the email address above.
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Email Address
Phone Number
I need to receive a receipt for donations for the month(s)
Select Month(s)
Please send me my Year-To-Date total for year(s)
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