ACH Recurring Payment Authorization
Recurring Payments Will Make Your Life Easier. Schedule your payment to be automatically deducted from your checking account. It’s convenient (saving you time and postage) and your payment is always on time (even if you’re out of town), eliminating late charges. Just complete and sign this form to get started!
Here’s How Recurring Payments Work. You authorize regularly scheduled charges to your checking account. You will be charged the amount indicated below each billing period. The charge will appear on your bank statement as an “ACH Debit.” Prior notification will be sent to the mailing address or e-mail address provided as a reminder of this debit if the transaction is dated more than three days from today’s date.
Please complete the information below:
I authorize Oliphant Financial, LLC to charge my bank account with the first payment and subsequent payments, at the amounts indicated, as further provided below.
I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Oliphant Financial, LLC in writing of any changes in my account information or termination of this authorization at least ten (10) days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF), I acknowledge that the Origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.