HEAT Direct Deposit Authorization Form

AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS

Independent Contractor Legal Name:

Enter the legal name that receives commission payments. If you are a sole proprietor, enter your personal legal name. If you operate as an LLC, Corporation, or other legal entity, enter the business's legal name.

Primary Name on the Bank Account (Depository):

The legal name above must match the name on your W-9 and the account receiving direct deposits.

I, authorize Happily Ever After Travel ("Company") to electronically deposit payments due to me into the financial institution account listed below. I also authorize the Company to initiate debit entries solely for the purpose of correcting an erroneous deposit, if permitted by law.

Depository:

Bank Name:

Branch Address:

City: , State:  

Zip:

Routing Number:

Account Number:

Re-enter Account Number:

Type of Account:

This authority is to remain in full force and effect until COMPANY and DEPOSITORY has received written notification for its termination in such time and in such manner as to afford COMPANY and DEPOSITORY reasonable opportunity to act on it.

Name Printed:

Date:

Happy State Bank Treasury Management Services Agreement
Automated Clearing House (ACH) Services Agreement - Schedule ACH