I authorize to electronically debit my checking account number (and, if necessary, electronically credit my checking account to correct erroneous debits) for the amounts listed on a monthly basis as follows:

I agree that the ACH transactions I authorize comply with all applicable law. I understand that this authorization will remain in full force and effect until I notify by email at email address or by mail to address. I also understand that I may revoke all services listed, or specify which above listed service(s) to terminate, leaving the remainder authorized. Please allow at least 5 of days business days prior to the proposed effective date of the termination of authorization.