Payment Preferences Form
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Name
*
First Name
Last Name
Email
*
example@example.com
I am a:
Service Vendor/Contractor
Other
Payment Information
I would like to receive payment by
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Zelle
ACH
Bill pay (mailed check)
Visa gift card (via email)
Zelle contact information (email, phone, or Zelle ID)
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Name on Account
*
First Name / Business Name
Last Name
Bank Name
*
Routing Number
*
Account Type
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Checking
Savings
Account Number
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Proof of Account/Routing Numbers
*
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To verify account/routing numbers, please upload a PDF or screenshot from bank portal OR a voided check.
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of
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I hereby authorize Legendary Communities NFP to direct payment as indicated above via: 1) Zelle, 2) ACH direct deposit to the account indicated above at the depository financial institution named above, 3) Bill Pay mailed check to the address listed above, or 4) Visa gift card to the e-mail address listed above. For ACH, I acknowledge that the origination of any direct deposit transactions to the account must comply with the provisions of U.S. law. This authorization is to remain in full force and effect until Legendary Communities has received written notification of its termination from me, the vendor, in such time and in such manner as to afford Legendary Communities and Bank/Depository a reasonable opportunity to act on it.
*
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Submit Consent
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