This authorization is to remain in effect until COMPANY has received written notification from me (us) of its termination in such time and in such manner as to afford COMPANY, service provider, and BANK a reasonable opportunity to act on it.
This form will be retained for future transactions, however, transactions will not be initiated by COMPANY without proper authorization from the Individual.
Please attach ONE of the following documents for account verification:
Voided Check: A personal check for your bank account.
Deposit Slip: Many banks, even if they don’t provide pre-voided checks, offer direct deposit forms. These forms are like pre-filled direct deposit slips that you can provide.
Bank Documentation: A letter or statement on bank letterhead with your account information could work.