ACH Enrollment Form

Sri Guruvayurappan Temple
11620 Ormandy Street, Houston, TX 77035
Authorization for On‑Demand Electronic Funds Transfer
Please attach a voided check or bank statement and send the completed form to the address above.
Donating For
Contact Information
Authorization Statement

This is an authorization for Sri Guruvayurappan Temple, Houston to establish Electronic Transfer instructions to withdraw funds from my/our account indicated above. This authorization will remain in effect until Sri Guruvayurappan Temple, Houston has received written notification from me (and/or the joint account owner) of its termination. I (and/or the joint account owner) will give at least 2 weeks notice to Sri Guruvayurappan Temple, when I/we need to make any changes to the ACH transfer. I also authorize Sri Guruvayurappan Temple, Houston to verify my/our bank account information with the bank listed above.

After submission, status is set to pending. Admin can review and Accept/Reject in backend.

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