ACH Payments | OneKeel.ai

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ACH Authorization Form

Please complete the form below to authorize your ACH payment securely

Company Name(Required)

Financial Institution (Depository)(Required)

Branch(Required)

City(Required)

State(Required)

Zip(Required)

Routing Number(Required)

Account Number(Required)

Your Name(Required)

Dealership(s) this payment method applies to:

Email Address(es) for Invoices(Required)

Email Addresses (separated by commas)

Email Address(es) for Receipts(Required)

Email Addresses (separated by commas)

Please attach copy of voided check to this form.

Please attach copy of voided check to this form(Required)

Max. file size: 20 MB.

Authorization(Required)

I/we hereby authorize OneKeel.ai to debit entries to my (our) account indicated above at the depository financial institution named above, hereafter called DEPOSITORY, and to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.

This authorization is to remain in effect until OneKeel.ai has received written notification from me (or either of us) of its termination in such time and in such manner as to afford OneKeel.ai and DEPOSITORY a reasonable opportunity to act on it.

Date(Required)

Signature

Signature(Required)

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