PLEDGE FORM 313

I/We want to support IEC in the efforts to expand the premises for our community. Residing at (City) (State) (Zip) (Telephone Number) (Cell Number)
Email

I/We hereby authorize I.E.C Husaini and their financial institution to make withdrawals of the amount stated hereunder on a monthly basis from my bank account. Please attach a copy of voided check, If possible.

My Bank Account Details

Bank Name
Bank Address
Bank Routing Number
Monthly Amount Withdrawal $ Starting Date

I/we pledge:

or
By the grace of Allah I/we wish to make one-time donation in the amount of
$

Paid in one or two installments.

Payments can also be made via Credit Card

Your Pledge will be charged on or near 15th of each month. Please inform us of any changes to your credit card information by contacting fundraising leaders or 313@iehusaini.org

Card # Name on Card

Exp. Date Security Code

Billing Address City State Zip

Date

Record all infromationon on this form. Make all checks payable to IEC Expansion Project. Don’t mail cash. Tax deducatable receipts will be mailed for contributions over $250/yr. You can download addition forms from IEC website www.iechusaini.org. IEC is a registered charitable organization with IRS with Federal Tax ID# 23-7223818. IEC has permission from Marja to accept Khums.