HEAT Direct Deposit Authorization Form

AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS

Independent Contractor Legal Name:   

Legal Name is Your Name if you're a sole proprietor, or your business name if LLC or S Corp         

Primary Name on the Bank Account (Depository):  

I, hereby authorize Happily Ever After Travel (COMPANY) to initiate debit entries to my account indicated below and the depository named below, hereinafter called Depository, to debit the same to such account.

Depository:   

Bank Name:  

Branch Address:

City:   State:     Zip:  

Routing Number:  

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