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Electronic Funds Transfer Authorization Donor Agreement

Agree to Terms:
Read the following information and, at the bottom of this page, select the checkbox then click the Submit button to authorize the addition of the Electronic Funds Transfer feature to your Giving Account.

Electronic Funds Transfer Authorization
I ("I" means an Account Holder of a Giving Account) hereby authorize Fidelity® Charitable Gift Fund and its agents, affiliates, employees or successors (collectively, "Fidelity Charitable"), to provide me with the Electronic Funds Transfer Service. I acknowledge that I have read and agree to the terms of the Electronic Funds Transfer Disclosures (PDF). I agree that the information I provide in connection with the Electronic Funds Transfer Service is complete and accurate.

• ACH Authorization: I authorize Fidelity Charitable to initiate debit entries to my bank account at the financial institution (Financial Institution) designated above using the Automated Clearing House (ACH) or other payment transfer service chosen by Fidelity Charitable from time to time and upon my instructions. I agree that the origination of ACH transactions must comply with provisions of U.S. law. This authorization is to remain in full force and effect until Fidelity Charitable has received notice from me of its termination in such time and in such manner as to afford Fidelity Charitable and the financial institution a reasonable opportunity to act on it.



• Electronic Disclosures: I verify that I am able to view the disclosures associated with this Electronic Funds Transfer Service enrollment process in electronic form. I understand that I may obtain a paper copy at no charge by calling 800-952-4438. I can print these documents using the print function of my browser or save them to my hard drive using the save function.



• Bank Account Representation: I certify that the bank account information that I have provided represents either a personal savings account or personal checking account for which I am one of the registered account owners. If the bank account information is for a corporation or other business entity, I certify that I am authorized to act on behalf of the entity to enter into this transaction.



• Fidelity Charitable Acknowledgment: I acknowledge that I have read the current Fidelity Charitable Policy Guidelines: Program Circular and agree to the terms and conditions described therein. I understand that any contribution, once accepted by the Trustees, represents an irrevocable contribution to Fidelity Charitable and is not refundable to me. I represent that I am either a primary or secondary Account Holder on my Giving Account® at Fidelity Charitable. I hereby certify that, to the best of my knowledge, all information presented in connection with this form is accurate and I will notify Fidelity Charitable promptly in writing of any changes.