Authorization for ACH Debit                  
    To enroll in Automatic ACH Debit, fill out this form and submit.  
    If using savings, ask your bank for the Routing/Transit Number for your account as the savings deposit slip number may be different.  
    If using checking, be sure to use the number from your check as routing numbers can be different for wire transfers, online transactions, and different states.  
    Pictured below is a sample check to assist with locating the required information.  
     
     
  IMPORTANT! Please read and initial before submitting.          
    I (we) hereby authorize McCay Kiddy LLC, hereinafter called Company, to initiate debit entries to my (our) Checking Account/Savings Account (select one) indicated below at the depository financial institution named below, hereinafter called Bank, and to debit the same account.  I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of US Law.  
    This authorization is to remain in full force and effect until the signer provides written notification to McCay Kiddy of its termination in such time and manner as to afford McCay Kiddy a reasonable opportunity to act on it.  
    The ACH Debit information provided applies to debits for my:      
     
     
       
         
  Type your full legal name and initials below to agree to this electronic signature submission.
Doing so confirms agreement of the prior paragraphs and begins per effective date. 		 
   
(effective date)
  Banking and ACH Debit Information              
    Description of the Service(s) to be debited under this agreement (check all that apply):  
     
Any Services
Tax Work  
Project Work
Forensic Litigation  
     
Payment Plan
Bookkeeping
Consulting
Valuation Services  
     
Payroll Fees
Audit & Attestation          
         
           
 
(9 digits only - include leading zeros)
(account number - include leading zeros)
           
    To authorize McCay Kiddy to debit the balance due for the service(s) checked above, type balance due.  
           
(ex. 10th of the month, 5th & 20th of the month)
(date to begin)
     
If copy of voided check available, drag file here or click to browse and attach