ED4 Recurring ACH Payment Authorization Form

• You can obtain your bank details either directly from your bank or from the bottom of a check linked to the account you wish to use
• Account Number: Must be no more than 17 digits
• Routing/Transfer Number: Must be exactly 9 digits
• Please ensure all bank numbers are entered without hyphens or special characters
• Remember to attach a voided check from the bank account you wat debited

• This form must be signed by the individual authorized to issue checks from the account

• ACH auto payments will be processed on the 10th of every month.
• ACH auto payments cannot be processed from savings accounts or Canadian banking institutions.  Please provide a valid U.S. checking account.
• If you wish to switch to a different bank account, you must submit a revised form.

If you have any questions, please contact the District Office at:

Phone: 520-466-7336

Email: payments@caidd.com

This authorization form will remain in effect until either canceled in writing or an updated form changing the information is submitted.

I hereby authorize ED4 to automatically withdraw from my Checking Account the total amount due on my billing statement and to make deposits if necessary for error correction. I authorize the Financial Institution named above to accept such transactions initiated by ED4. The withdrawal shall be made from my account on the 10th day of the month or the following business day after a holiday. I am aware of my right to stop a withdrawal by notifying ED4 at any time up to three (3) business days before the withdrawal date. If an erroneous withdrawal occurs and I notify the Financial Institution of the error within 60 days of the issuance of my account statement, the institution must investigate and resolve the errorwithin 45 days of notification. If the error is not resolved within the first 10 business days following receipt of my notification, my account shall be re-credited for the amount in question until the investigation is completed. (Condensed for Regulation E, Electronic Fund Transfer Act for the consumer's protection. For more information, contact your Financial Institution.)