TRF Rentals ACH Direct Deposit/Debit Authorization

Consumer Authorization for Direct Funds Transfer Via ACH

(ACH Debits and Credits)
Direct Funds Transfer via ACH is the transfer of funds from or to a consumer account for the purpose of making a payment or credit to the account.
Name(s) on the Account:*
Depository Name / Bank Name:*
Check one:*

Begin Payment / CreditChange InformationEnd Payment / Credit
I (we) hereby authorize Thief River Falls Rentals LLC (“COMPANY”) to electronically debit and/or credit my (our) account (and, if necessary, to electronically credit and/or debit my (our) account to correct erroneous debits and/or credits) as follows, at the depository financial institution named below ("DEPOSITORY"). I (we) agree that ACH transactions I (we) authorize comply with all applicable law.
Account Type*

Personal Checking AccountPersonal Savings AccountBusiness Checking AccountBusiness Savings Account
Routing Number:*
XXXXXXXXX 9 digits
Account Number*
Confirm Account Number*
Amount authorized to debit(s) and/or credit(s) or method of determining amount of debit(s) and/or credit(s): Amount owed each month, to debit and/or credit on the 1st available day of each month, in the amount of:
Once per Month
I (we) understand that this authorization will remain in full force and effect until I (we) notify Thief River Falls Rentals, LLC in writing, that I (we) wish to revoke this authorization. I (we) understand that Thief River Falls Rentals, LLC requires at least five (5) business days prior notice to cancel this authorization.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Signature*

Clear
Should be Empty:

Consumer Authorization for Direct Funds Transfer Via ACH

Direct Funds Transfer via ACH is the transfer of funds from or to a consumer account for the purpose of making a payment or credit to the account.