ACH - PowerPay

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

Debit Card or ACH/Checking(Required)

Name of Bank or Financial Institution (”Bank”)(Required)

Bank Routing(Required)

Checking Account Number(Required)

Name on the Card(Required)

Debit Card Number(Required)

Expiration Date(Required)

CVV Code(Required)

Billing Zip Code(Required)

Loan or Application ID(Required)

Date(Required)

Customer First Name(Required)

Customer Last Name(Required)

Loan Application Number(Required)

Mobile Number(Required)

Customer Signature(Required)

I AGREE

By providing the information above you authorize PowerPay LLC. (“Company”) to initiate recurring electronic automated clearing house (ACH) debit entries from your Checking Account indicated above, at the Bank named above, to make payments on your PowerPay LLC account and, if necessary, to initiate transactions to correct any erroneous payment debit. See complete terms and conditions.

Your AutoPay payments will begin when your project is complete, at the end of a promotion period, or in some cases, at the seventh month after the execution of the loan. Payments will occur on the on the same date each month thereafter until your PowerPay LLC. account is paid in full, terminated by Company (as provided below), or you revoke this authorization. If any payment date falls on a weekend or holiday, the payment will be executed on the next business day. If the outstanding balance you owe on your PowerPay LLC. contract is less than the payment amount stated above, you understand and agree that the final payment will be an amount equal to your total outstanding balance.

If your Bank is unable to process any electronic ACH debit entry, you authorize Company to resubmit the ACH debit entry within the next 3 to 5 business days, and/or to submit a paper draft to your Bank for processing and payment. If your payment (whether in the form of an electronic ACH debit or a paper draft) is dishonored or returned unpaid by your Bank, you agree that Company may charge a return item fee and/or a late charge (if and to the extent applicable) to your PowerPay LLC account, to the extent allowed by law and/or your PowerPay LLC. contract. You also acknowledge that your Bank may also impose its own additional fees according to your Deposit Account Agreement with such Bank. You acknowledge that the origination of ACH debit entries to your Checking Account must comply with and will be governed by the provisions of applicable laws and rules of the National Automated Clearing House applicable to the transaction.

This authorization will remain in full force and effect until the Company has received written notification from you (or either one of you) of termination at the address above or you have provided verbal notification by calling us at (866) 615-4339. You agree to notify Company in writing of any changes in your Checking Account information or termination of this authorization at least 15 days prior to the next billing date to afford a reasonable opportunity for Company and Bank time to act. Company may, at any time, terminate your right to make recurring electronic clearing house (ACH) debit entries. Termination of this authorization by either you or us does not affect your PowerPay LLC. account.

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

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