Use this form to enroll in AutoPay – the easiest way to make your monthly payments. With AutoPay, there are no checks to
write or calls to make. Your payments will automatically be transferred from your checking account to PowerPay LLC every
month by ACH transfer.

To enroll in AutoPay, complete the form below and sign.
Have a question? Call (866) 615-4339
Office hours: Monday-Friday 8am – 6pm. (Eastern Time)

Authorization Agreement for Recurring Automated Direct Payment Plan
For Debit Card or ACH/Checking