RECURRING PAYMENT AUTHORIZATION FORM

RECURRING PAYMENT AUTHORIZATION FORM

You authorize regularly scheduled charges from your bank account. You will be charged each billing period (30 days) for the total amount due for that period, stated below. You agree that no prior-notification will be provided unless the payment amount or payment date changes, in which case you will be notified at least 10 days prior to the payment being collected and that sufficient funds are available for the monthly transfer.