ACH Payment Authorization
One Time ACH Payment Authorization Form
Sign and complete this form to authorize QB ADVISORS to make a one-time debit to your checking or savings account.
By signing this form, you give us permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits or credits to your account.
Please complete the information below:
I authorize QB ADVISORS to charge my bank account indicated below for USD on or after . This payment is for .
I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above-noted transaction date. In the case of the payment being rejected for Non-Sufficient Funds (NSF), I understand that QB ADVISORS may at its discretion attempt to process the charge again within 30 days. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I will not dispute QB ADVISORS billing with my bank so long as the transaction corresponds to the terms indicated in this agreement.
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If you have questions about the contents of this document, you can email the document owner.
Document Name: ACH Payment Authorization
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