Electronic Funds Transfer
Statement of Authorization
Your gift through Electronic Funds transfer (EFT) is a win-win: for you, it's a convenient, easy way to support Indiana
University, and, at the same time, gift-processing costs are reduced so your gift achieves more. When you enroll, your gift
will automatically transfer from your checking account or be billed to your credit card. All gifts are processed around the
15th of each month and will appear on your checking account or credit card statement. You may change or cancel your
gifts at any time by notifying us of the change in writing. Thank you for your continued support of Indiana University.
HOME PHONE #
WHAT YEAR DID
PLEASE CHECK IF THIS GIFT
IS ALSO FROM YOUR SPOUSE
SPOUSE’S LAST NAME
MONTHLY GIFT AMOUNT
I WOULD LIKE MY GIFT TO BENEFIT
(MINIMUM GIFT IS $10 MONTHLY)
(PLEASE SPECIFY COLLEGE, CAMPUS, LIBRARY, SPECIAL PROGRAM, OR ACCOUNT)
MONTHLY TRANSFER FROM CHECKING ACCOUNT. PLEASE ATTACH A VOIDED CHECK.
NOTE: WE ARE REQUIRED TO COLLECT A VOIDED CHECK; A DEPOSIT SLIP WILL NOT MEET THIS REQUIREMENT.
MONTHLY CREDIT/DEBIT CARD CHARGE:
I authorize the Indiana University Foundation to initiate the recurring credit card charge or EFT withdrawal as indicated above. I understand that a record of each donation will be
included on my monthly credit card or bank statement and that the Indiana University Foundation will send a receipt showing the total of all recurring gifts for the calendar year
following the end of each calendar year. I may change or cancel this recurring payment by notifying the IU Foundation in writing. All notifications must be received by the first of
the month in order to alter the month’s transaction.
If I have elected to pay by credit card, I agree