Authorization for Electronic Funds Transfer. I (We) hereby authorize Hawthorn Farm Athletic Club & Spa, hereinafter called the CLUB, to initiate debit entries into my (our) account at the financial stated on the check, hereinafter called the BANK. This authority is to remain in full force and effect until the CLUB and BANK have received written notification from me (us) of termination in such a time and in such a manner as to be consistent with this Agreement and afford the CLUB and the BANK a reasonable opportunity to act on it. A VOIDED CHECK CAN ACCOMPANY THIS COMPLETED FORM. HFAC MEMBER RULES & REGULATIONS
Authorization for Electronic Funds Transfer. You hereby authorize International Business Machines Corporation to initiate credit entries to the account listed below in connection with agreed upon Electronic Data Interchange (EDI) transactions between our companies. You agree that such transactions will be governed by the National Automated Clearing House Association rules. This authority is to remain in effect until International Business Machines Corporation has received written notification of termination in such time and such manner as to afford International Business Machines Corporation a reasonable opportunity to act on it. IN NO EVENT SHALL IBM BE LIABLE FOR ANY SPECIAL, INCIDENTAL, EXEMPLARY OR CONSEQUENTIAL DAMAGES AS A RESULT OF THE DELAY, OMISSION OR ERROR OF AN ELECTRONIC CREDIT ENTRY, EVEN IF INTERNATIONAL BUSINESS MACHINES CORPORATIONS HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Trading Partner Name Payment Remit Address Account Payee Payee Address EFT Domestic Banking Institution Contact Name / Title Contact Phone Number Bank Address Account Number (MAX 17) Bank Routing / Transit CD (MAX 9) DUNS Number / User ID / Account Number Tax ID Number By Name Title Phone Number Date
Authorization for Electronic Funds Transfer. I hereby authorize THE OVERLOOK BOULDER + FITNESS to initiate debit entries to the Credit Card on file, and/or adjustments for any debit entries made in error. I hereby authorize the financial institution named below to credit and/or debit the same to such account. This authorization is to remain in full force and effect until THE OVERLOOK BOULDER + FITNESS has received written notification from me of its termination. In signing this document, I acknowledge that I have read, understood, and agree to comply with all provisions of this Agreement and the Release Agreement. SIGNATURE(S)
Authorization for Electronic Funds Transfer. The parties agree that this Authorization for Electronic Funds Transfer hereby amends the agreements between (“Company” or “you”) and Intuit Inc. (“Intuit”) to accept electronic payments. Company authorizes Intuit to make electronic payments to your account specified below. You agree that such transactions shall be governed by the National Automated Clearing House Association (ACH) rules. This authority shall remain in effect until Intuit receives written notification of termination from you through your authorized contact person in such time and such manner as to afford Intuit a reasonable opportunity to act on it. You also authorize the bank listed below to verify your account information in order to establish the Electronic Funds Transfer (EFT). IN NO EVENT SHALL INTUIT BE LIABLE FOR ANY SPECIAL, INCIDENTAL, EXEMPLARY OR CONSEQUENTIAL DAMAGES AS A RESULT OF THE DELAY, OMISSION, OR ERROR OF AN ELECTRONIC CREDIT ENTRY, EVEN IF INTUIT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. You are required to provide Intuit with prompt written notice of the initiation, change, or termination of any relationship in which you authorize a third party to receive payment from Intuit on your behalf. Payments made by Intuit to a third party whom you authorize within this form to accept payments on your behalf shall satisfy Intuit’s payment obligation to you. You will allow at least thirty days (30) from the date of receipt of this document by Intuit before activation. This agreement shall be governed by the laws of the State of California. COMPANY / PAYEE NAME REMIT TO: ADDRESS This should be the remit to: address shown on your invoices Street Address / P.O. Box City, State, Zip: Company Tax ID Number: BANKING INFORMATION This must be a U.S. domestic bank to use this form Name of Bank: Street Address / P.O. Box: City, State, Zip: Title on Bank Account*: (Should Read Exactly as Listed on Bank Statement) *If Name on your bank account differs from the Company name, provide a description of relationship (ex: parent/sub or factoring company) on your company letterhead, attach documentation of the relationship, and check the box here to indicate that the other entity is an agent of Company and it is authorized to accept payments from Intuit on behalf of Company: [ ] EFT INFORMATION Obtain this information directly from your bank Bank Routing Number: (also known as ABA Number) Bank Account Number: BANK CONTACT Xxxxxx at your bank who we can contact to verify banking inform...
