(Print form, complete, and return to US36.Net)
AUTHORIZATION FOR DIRECT PAYMENTS (ACH DEBITS)
I(we) hereby authorize US36.NET, hereinafter called COMPANY, to initiate debit entries to my(our) ( )Checking ( )Savings account (select one) indicated below and the depository financial institution named below, hereinafter called DEPOSITORY, and to debit the same account. I(we) acknowledge that the originations of ACH transactions to my(our) account must comply with the provisions of U.S. law.
TRANSIT/ABA NO._____________________ACCOUNT NO.______________________
This authority is to remain in full force and effect Until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to give COMPANY and DEPOSITORY a reasonable opportunity to act on it.