Direct Payment Authorization

Consumer Authorization for Direct Payment via ACH( ACH Debit)


Direct Payment via ACH is the transfer of funds for a consumer account for the purpose of making a payment.
I(we) authorize Indiecrowdfund to electronically debit my (our) account (and, if necessary, electronically credit my (our) account to correct erroneous debits) as follows:
at the depository financial institution named below ("DEPOSITORY"). I (we) agree that ACH transactions I (we) authorize comply with all applicable law.
I(we) understand that this authorization will remain in full force and effect until I (we) notify Square Peg Media Group [insert manner of revocation, i.e., in written, by phone, location, address, etc.] that I (we) wish to revoke this authorization. I (we) understand that Square Peg Media Group requires at list 7 days prior notice in order to cancel this authorization.
Type Your Name for Signature

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