Recurring ACH Payment Authorization

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You authorize regularly scheduled charges to your checking/savings account. You will be charged the amount required to cover each pay period. A receipt for each payment will be provided to you and the charge will appear on your bank statement as an “ACH Debit”. You agree that no prior notification will be provided unless the date changes, in which case you will receive notice from us prior to the payment being collected.

*YOU MUST PROVIDE iAS WITH A COPY OF A VOIDED CHECK OR PREPRINTED ACCOUNT INFORMATION / DIRECT DEPOSIT FORM FROM THE BANK*

Billing Information*
Bank Details*

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify iAS in writing of any changes in my account information or termination of this authorization at least 10 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates.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 understand that iAS may at its discretion attempt to process the charge again within 30 days, and agree to an additional $35 charge for each attempt returned NSF which will be included in the transaction with the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this bank account and will not dispute these scheduled transactions with my bank; so long as the transactions correspond to the terms indicated in this authorization form.

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