Authorization for Direct Deposit

CONSUMER AUTHORIZATION FOR DIRECT DEPOSIT VIA ACH (ACH CREDITS)

Direct Deposit via ACH is the deposit of funds to a consumer’s account.

I (we) hereby authorize CleanIt LLC (“COMPANY”) to electronically credit my (our) account (and, if necessary, to electronically debit my (our) account to correct erroneous credits) as follows:

Type of Account:

Routing Number: Account Number:
Your Full Name, as seen on Account:

Photo of Voided Check:

Upload Voided Check Here

I (we) understand that this authorization will remain in full force and effect until I (we) notify COMPANY in writing via email that I (we) wish to revoke this authorization. I (we) understand that COMPANY requires at least 2 weeks prior notice in order to cancel this authorization.

  1. Independent Contractor:

    Contractors Signature:



9/10/2020 @ 11:21:52 undefined (UTC)

Enter your email to receive a copy of this signed document:

Privacy & Cookies

This site uses cookies. By continuing to use this website, you agree to their use. To find out more, including how to control cookies, see here Cookie Policy

Accept Decline