Electronic Check Authorization Form

Authorization Agreement

Recurring transactions

I authorize Farmboy, Inc to initiate either an electronic debit or to create and process a demand draft against my bank account according to the terms of our work agreement contract(s). I acknowledge that the origination of ACH transactions to my account must comply with the provisioning of United States law.

Bank Information

Bank ABA Number:   

Bank Account Number:  

Bank Account Type

This payment authorization is to remain in full force and effect until I notify Farmboy of its cancellation by sending written notice in such time and in such manner to allow both the Farmboy Accounting department and receiving financial institution a reasonable opportunity to act on it.

Signature

Company: