Gigabit Business Consulting

Direct Payment via ACH Authorization


Direct Payment via ACH is the transfer of funds from a checking/savings account for the purpose of making a payment. I authorize Gigabit Business Consulting LLC to electronically debit the following account (and, if necessary, electronically credit the account to correct erroneous debits) as follows:

Account Type:

 

Routing Number:

Confirm Routing Number:

 

Account Number:

Confirm Account Number:

 

I authorize debit amounts on a one-time and recurring basis per signed orders and/or signed statements of work. I agree that ACH transactions I authorize comply with all applicable law. I understand that this authorization will remain in full force and effect until I notify Gigabit Business Consulting LLC in writing, by mail, to 240 N East Promontory Ste 200, Farmington, Utah 84025, that I wish to revoke this authorization. I understand that Gigabit Business Consulting LLC requires at least three (3) business days’ prior notice in order to cancel this authorization.

 

Full Name:

Company:

Date Signed: 

Leave this empty:

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Signature Certificate
Document name: Direct Payment via ACH Authorization
lock iconUnique Document ID: d08ff2f058b5011c4c1d844d7b89d360c12bce35
Timestamp Audit
July 17, 2017 9:53 am MDTDirect Payment via ACH Authorization Uploaded by Joshua Barneck Barneck - joshua@gigabit.com IP 206.190.197.236
October 28, 2019 7:53 pm MDTJoshua Mobile - 8018891221@vtext.com added by Joshua Barneck Barneck - joshua@gigabit.com as a CC'd Recipient Ip: 67.163.71.143