ContractAch Debit Agreement • December 10th, 2015 • Florida
Contract Type FiledDecember 10th, 2015 JurisdictionDEBIT INFORMATION Day of Week ACH Debits are Withdrawn: (circle one) M T W TH F Date of First Debit: (MM/DD/YYYY) Debit Amount: (does not include debit fee) ACH/Convenience Fee: $0.25 Weekly Biweekly Bimonthly Monthly