CONSUMER ACH / DEBIT CARD PAYMENT /RCC AUTHORIZATION FORM

 

ACCOUNT HOLDER FULL NAMES AND SURNAME :

JOHN WEST

Account holder SSN:

XXXXX3021

 

 

Name:

UPAY Inc.

Exp:

9 / 2026

 

 

Card type:

DEBIT

Card #:

49xxxxxxxxxx5716

Card Billing Address:

xxx TEST ADDRESS XXXX

Acc type:

CHECKING

Acc #:

  24xxxxxxxx1

Routing #:

103100195


 

 

Hereby admit, confirm and declare that:

 I am of the intent to purchase products and services from UPAY Inc. (herein after called THE COMPANY), and that this authorization will be instrumental in the management of payments of such.

 That THE COMPANY, is expected to Manage the payments due in respect of such agreement;

 Therefore I must enable the COMPANY with the ability to manage such payments to the best of its ability, to ensure the best chance of success on such payments, by having:

Full and continuous access to my bank account, to establish the timing, frequency and amounts of Recurring Expenses and Income Payments;

The right to adjust the timing of such payments to synchronize the submissions with the expected receipt dates and times of my Income Payments;

The right to make use of any payment method, or combination of payment methods available, with the best chance of success;

 That I wish to make the payments towards above-mentioned products and services by way of electronic deductions or payment transactions against my bank accounts;

 That each of these scheduled payments in respect of the products and services mentioned above, must be regarded as herewith individually and separately mandated in terms of resubmission of such payments;

 That I wish my bank and THE COMPANY to assist me in every way possible to obtain the products and services, and to facilitate and manage the resulting payments by way of electronic payment methods as available to THE COMPANY;

 That I give this authorization voluntarily.

  1. Therefore, I hereby request, instruct, authorize and mandate:
    • 2.1.THE COMPANY to act with full power of attorney on my behalf in terms of all actions needed to affect such electronic payments by utilizing, but not limited to, the following services:
      • 2.1.1.Electronic Balance Enquiries through EFT, ACH or Card transactions;
      • 2.1.2.3rd party Bank Account Aggregation Services;
      • 2.1.3.Debit Pull or Credit Push transactions, utilizing any one or a combination of:
        • 2.1.3.1.Electronic Funds Transfer (EFT) or
        • 2.1.3.2.using a paper or electronic Automated Clearing House (ACH) transaction, or
        • 2.1.3.3.a card transaction utilizing any bank cards issued on above bank accounts, or any other cards and accounts acquired previously or in future, or
        • 2.1.3.4.a Remotely Created Check (RCC);
    • 2.2.That all such withdrawals from and transactions against my bank accounts initiated by THE COMPANY shall be treated by all parties concerned, including my bank, as if they were initiated, authorized and signed by me personally.
    • 2.3.The above power of attorney to be used in order to effect payment from my bank accounts (bank accounts as stipulated above, or any other bank account which I may utilize in future) of the amounts necessary for the regular payments due in respect of the products and services mentioned in clause 1 above, on the days coinciding with my salary or any other regular income payment dates, until all monies due are paid in full;
    • 2.4.This Mandate, Power Of Attorney And Instruction to be valid from date of signing hereof, authorization to EFT/ACH and to charge my Card will remain in full force and in effect until I terminate it by giving the THE COMPANY written notice at least three (3) business days prior to the payment due date and until THE COMPANY has had a reasonable opportunity to act on my notice at THE COMPANY’s address listed on the Agreements, and up to a maximum amount not exceeding the total amounts due in respect of the products and services mentioned in clause 1 above.
    • 2.5.THE COMPANY to make use of a third party as my agent to process my Payment or Repayment.
    • 2.6.THE COMPANY to collect from my account at such dates and times as THE COMPANY may deem fit, as the dates and times

THE COMPANY


may regard as the practical submission payment and repayment date(s) with the best chance of success.

  • 2.7.That any bank and payment system charges and penalty charges arising from the successful or unsuccessful payment or repayment shall be for my cost.
  • 2.8.That I voluntarily authorize the above collection of the total of payments in one full amount or varying amounts by electronic means from my Bank Accounts and/or Card(s).
  • 2.9.The COMPANY to have full rights to at any time cede any and all rights in terms of this authorization to any other party of the COMPANY's choice.

 

 

“By signing this agreement, I declare that I have thoroughly acquainted myself with everything contained on the “Disclosure Tab” on the website of UPAY In’s subsidiary HUNTPALL LLC, as to be found at https://www.huntpal.net, and agree and submit to all disclosures, policies, procedures and other detail contained therein.”


 

 

Signature Client

 

 

 

 

Signature Details:

Name:

Signed On: 10/14/2023 12:58:12 PM

 

I certify that I am an authorized signer for the account indicated above and that I have the authority to authorize this/these transactions. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted transaction date, and that I will have limited time to report and dispute errors. In the case the transaction is returned for Non Sufficient Funds (NSF) I understand that THE COMPANY may at its discretion attempt to process the charge again within 30 days, and agrees to an additional $35 charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized payment. I have certified that the above bank account is enabled for ACH transactions, and agree to reimburse THE COMPANY for all penalties and fees incurred as a result of my bank rejecting ACH debits or credits as a result of the account not being properly configured for ACH transactions. Both parties agree to be bound by NACHA Operating Rules as they pertain to this transaction. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this transaction with my bank provided the transaction corresponds to the terms indicated in this authorization form.