Animal Friends of Barbour County
We are pleased to offer you an easy way to send your donation to us through the Direct Payment Plan.

Now you can have your donation automatically deducted from your checking or savings account. And, you won’t
have to change your present banking relationship to
 take advantage of this service.

The Direct Payment Plan will help you & us in several ways:

    It saves time - fewer checks to write and mail.

    It helps get your donation to us always on time -
        even if you are on vacation or out of town.

              It saves you money on postage.

      It’s easy to sign up for, and easy to cancel.

Here’s how The Direct Payment Plan works:

You authorize regularly scheduled payments to be made  from your checking or savings account. Your payments will be made automatically on the specified day of the month or day of a specific month. Proof of payment will appear on the statement you receive from your financial institution.

                           Please complete the information below and mail it to  AFOBC  PO Box 452  Philippi  WV  26416

I authorize Animal Friends of Barbour County, West Virginia to initiate electronic debit entries to my

_____ checking account       OR      ______ savings account

  for payment of my donation of $ _____________ to be deducted on

   the ______ of every month    OR    Yearly on the ______ of specific month: ______

I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.

This authority will remain in effect until I have cancelled it in writing to AFOBC PO Box 452 Philippi WV 26416


Your Name  __________________________________________________        Phone # ________________________

Financial Institution name___________________________________________________________________________

Financial Institution City_____________________________               Financial Institution State____________________

Account # at Financial Institution______________________        Financial Institution Routing #____________________

Today’s Date______________________    Signature_____________________________________________________

The authority you give us to debit your account will remain in effect until you notify us, in writing, to terminate this authorization.

The address you would write to is:
   AFOBC   P.O. Box 452,  Philippi WV  26416

To take advantage of this easy way to help us:

1) Mark the box by type of account to indicate whether your payment will be deducted from your checking or savings account.

2)  Enter donation amount to be debited.

3)  Enter when donation is to be debited.

4) Fill in your name, phone number, and Financial Institution’s name, City and State.

5) Attach a voided check for your account number and Financial Institution’s routing number. If you are unable to attach the voided check, please fill in the routing number (1st set of numbers on check), and account number (middle set of numbers on check).

6)  Be sure to date and sign the form at the bottom.