Instructions:
To setup, change, or discontinue your Automatic Withdrawal, you have 3 options.
- Complete and submit the online form below.
- OR -
- Download the fillable PDF form and complete it on your computer. Then save the file and email it to stmary@stmaryalexandria.org along with a scanned copy of a voided check.
- OR -
- Download the PDF form, print and complete it. Then mail to St. Mary's (420 Irving St., Alexandria, MN 56308) along with a voided check.
Automatic Withdrawal Form
This is an automatic withdrawal authorization agreement form.