Document text
Name: [FULL NAME]
What I am saving for: [MY GOAL — e.g. EMERGENCY FUND, HOLIDAYS, A TRIP]
Target: $[AMOUNT]
How I save: [100 ENVELOPES: ENVELOPE N × $[STEP], ONE A DAY / 52 WEEKS: WEEK N × $[STEP] / SAME AMOUNT: $[AMOUNT] EVERY WEEK]
Start: [DATE]
Last deposit: [DATE]
Where the money goes: [ENVELOPES AT HOME / SEPARATE SAVINGS ACCOUNT / RECURRING TRANSFER]
My envelopes
Tick the box every time you fill one. Any order works — the total stays the same.
Envelope Amount Done Envelope Amount Done
1 $[1 × STEP] ☐ 51 $[51 × STEP] ☐
2 $[2 × STEP] ☐ 52 $[52 × STEP] ☐
3 $[3 × STEP] ☐ 53 $[53 × STEP] ☐
4 $[4 × STEP] ☐ 54 $[54 × STEP] ☐
5 $[5 × STEP] ☐ 55 $[55 × STEP] ☐
6 $[6 × STEP] ☐ 56 $[56 × STEP] ☐
7 $[7 × STEP] ☐ 57 $[57 × STEP] ☐
8 $[8 × STEP] ☐ 58 $[58 × STEP] ☐
9 $[9 × STEP] ☐ 59 $[59 × STEP] ☐
10 $[10 × STEP] ☐ 60 $[60 × STEP] ☐
… … ☐ … … ☐
50 $[50 × STEP] ☐ 100 $[100 × STEP] ☐
Checkpoints: envelope 25 — $[TOTAL]; envelope 50 (halfway) — $[TOTAL]; envelope 75 — $[TOTAL]; envelope 100 — $[TOTAL].
My pledge
I will fill my envelopes from [DATE] to [DATE], and I will not spend this money before then except for a real emergency. If I miss a day, I catch up the next one.
When I finish, I will [MOVE IT TO SAVINGS / USE IT FOR MY GOAL].
Signature: ____________________ / [FULL NAME] /
Date: [DATE]
Request to set up a recurring transfer to my savings account
To: [BANK NAME], [BRANCH]
From: [FULL NAME], customer no. [NUMBER], phone [PHONE]
Please set up a recurring automatic transfer of the amount below from my checking account to my savings account, both in my name:
Item Details
From account Checking, account no. [NUMBER]
To account Savings, account no. [NUMBER]
Amount of each transfer $[AMOUNT]
Frequency weekly (every [WEEKDAY])
First transfer [DATE]
Last transfer [DATE]
Memo Savings challenge
I can cancel or change this instruction at any time. Please confirm the set-up in writing.
Account holder's signature: ____________________ / [FULL NAME] /
Place and date: [CITY], [DATE]
Reply to this document or get a deadline reminder: https://layers.md/us/100-envelope-challenge?from=reply-us-100-envelope