BANK ACH AUTHORIZATION AGREEMENT

The account holder listed below hereby authorizes Best Martial Arts Institute (hereinafter “Vendor”) to withdraw any amounts, including any and all sales now due or hereinafter imposed, owed by Customer by initiating debit entries to Customer’s account at the financial institution (hereinafter “Bank”) indicated in this agreement or at any such other Bank as Customer may from time to time use.  In the event of default of Customer’s obligation hereunder, Customer authorizes debit of Customer’s account for the full amount due under this Agreement or any portion thereof.  Further, Customer authorizes Bank to accept and to charge any debit entries initiated by Vendor to Customer’s account.  In the event that Vendor withdraws erroneously from Customer’s account, Customer authorizes Vendor to credit Customer’s account for the amount erroneously withdrawn.  Customer understands that the foregoing ACH authorization is a fundamental condition to induce Vendor to accept this Agreement.  Consequently, such authorization is intended to be irrevocable and if cancelled, Customer authorizes Bank to pay a single and final ACH debit to Vendor equal to any balance due on Agreement. In the event that Vendor is unable to collect any ACH debit to Customer, in its sole discretion, may either deem such an event as default in accordance with the Agreement or may invoice Customer for payments due under this Agreement and include a $10.00 processing fee in such invoices. 

Debit my account for fees incurred by the following members of Best Martial Arts Institute:

(Student's Name)

Bank Account Holder's Name:

Phone:  Email:  

Bank Name:  

Routing # (9 digits) Account #   

Type of Account: 

Requested Date to Take Effect:  

Amount to Withdraw for Monthly Tuition: $ Find Our Monthly Rates Here

UPLOAD A VOIDED CHECK FROM THE ACCOUNT LISTED ABOVE:

(or any bank document showing your name, account number, and routing number.)

(Allowed file extensions - jpg, jpeg, jpe, gif, png, pdf)

ACH funds transfers will occur on the 1^st day of the month for which payment is due.

Notice must be given by the 15^th day of the month to stop an ACH payment for the coming month.

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Document name: ACH Authorization

Unique Document ID: 8565a56a95841266180b46c531b65142c327ef20

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Timestamp	Audit
December 14, 2021 10:07 pm PST	ACH Authorization Uploaded by Alan Best - Bestmartialartsinstitute@gmail.com IP 71.236.137.206

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Audit Trail Serial# 8f8a3d0424e7c6a623f9db24fb453ab3