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This agreement governs ACH transactions initiated by authorize Fusioncorp to credit or charge the authorize your Company indicated below. Both parties agree to be bound by NACHA Operating Rules as they pertain to all ACH transactions initiated by authorize Fusioncorp that credit or debit your company's bank account listed below, and acknowledge that the origination of ACH transactions to the listed account must comply with provisions of U.S. law. This agreement provides authorization for individual or recurring CCD transactions to be initiated by Fusioncorp when individually authorized using the methods designated below. This agreement will remain in effect until your Company cancels it in writing. Both parties agree that this agreement, in conjunction with any of the designated methods constitutes authorization to debit your Company’s business bank account, and you agree not to dispute any debits with its bank provided the transaction(s) correspond to the terms indicated in this agreement.
I certify that I am an authorized representative of the Company indicated above and that I have the authority to enter into this Agreement on the Company’s behalf. Company understands that this authorization will remain in effect until it is canceled in writing, and agrees to notify said company in writing at least 15 days in advance of any changes in its account information or termination of this authorization. This Company understands that because these are electronic transactions, these funds may be withdrawn from its account as soon as the date an individual transaction is authorized, and that it will have limited time to report and dispute errors. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) Company understand that Fusioncorp may at its discretion attempt to process the charge again within 30 days, and agrees to an additional $50.00 amount charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized payment. You have certified that the above business bank account is enabled for ACH transactions, and agrees to reimburse Fusioncorp for all penalties and fees incurred as a result of Your COmpanies bank rejecting ACH debits or credits as a result of the account not being properly configured for ACH transactions. You acknowledge that the origination of ACH transactions to its account must comply with the provisions of U.S. law.

Enter Checking Account Details

Sign and complete this form to authorize Fusioncorp to make regularly scheduled charges to your bank account. By signing this form, you give us permission to debit your account for the amount indicated below each billing period until the designated expiration date. You agree that no prior notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.
I understand this authorization will remain in effect until I cancel it in writing and I agree to notify Fusioncorp in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF), I understand that Fusioncorp may attempt to process the charge again within 30 days, and agree to an additional $50.00 amount charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.