This is the current PaymentsWiki form for ACH
Please make the following three changes to this form:
- Please add, if possible, a graphic image similar to this above the routing number and account fields:
- Please also add language such as this below the routing and account fields to guide the donor on the character count (this will help avoid wrong numbers being entered or routing being transposed for acct#):
- Finally, please add to the bottom of the form: "I authorize Wikimedia Foundation to electronically debit my account in the amount of $xx.00 on the agreed upon schedule. I understand that a recovery fee may be charged if the payment is dishonored or returned for any reason and that it is my responsibility to retain a copy of this authorization for my records."



