Helping Hands Ministry, Inc. (a Non-Profit 501(c)3 Organization)
P.O. Box 337 or 135 Main St.,
Tallulah Falls, GA 30573
Tel. 706-754-6884
Fax 706-754-9247
www.hhmin.org
 

CREDIT CARD DEBIT AUTHORIZATION FORM

(for Tax Deductible Donations)

If you would like a tax receipt for your giving to Olivia, you can send a check to Helping Hands with Olivia King written in the memo of your check. They will immediately send you a receipt for your gift. If you would like to donate by way of credit card, you can copy and paste the form below to MS Word, fill it out, print it out and mail it to the same address. You can also donate by way of “Make A Donation” that goes through PayPal and their receipt they send you can be used for tax purposes.

___________________________________________________ (print name as listed on card) hereby authorizes Helping Hands Ministry, Inc., to debit the account listed below. *

(Please circle one):    Visa     (or)     MasterCard

# ___________-___________-___________-___________,     3 Digit Security # __________ (see back of card)

Expiration Date: ________/_________ (month / year)


Signature: ______________________________________________

Debit Amount: $_____________.00

Frequency (check one): Monthly______ Quarterly______ Annually______ One-time_______

Perform Debit Transactions beginning on: ________/_________/_________ (month/date/year)

Billing Address (address must match billing address for the account listed above):

Street: _______________________________________________________

City: _______________________     State: ___________     Zip: _____________

Tel:(____)_______-________   Email: ______________________________

Tax Deductible Donations for:       OLIVIA KING      


Fill out complete, and return to Helping Hands Ministry at the address or fax listed at the top.

* This authorization can be terminated at any time in writing by the cardholder only.