Automated Recurring Donation Agreement

This agreement form authorizes Servolution Health Services to transfer funds from a donor's personal or business bank account on a monthly basis.

Automated transfers from the account will be made on the 15th day of each month. This agreement will remain in effect until a written notification from the donor is received.

@ 2021 Servolution Health Services
181 Powell Valley School Lane, Speedwell, Tn 37870
Tennessee Comptroller of the Treasury:
Citizens and agencies are encouraged to report fraud, waste, or abuse in State and Local Government.
NOTICE: This agency is a recipient of taxpayer funding. If you observe an agency director or employee engaging in any activity which you consider to be illegal, improper, or wasteful, please call the state Comptroller's toll-free Hotline: 1-800-232-5459
Notifications can also be submitted electronically at: