EmailMe Form - ACH Bookkeeping Agreement

Date Time *

MM / DD / YYYY

Name *

First Last

Company Name *

Email *

Web Site

Phone *

### - ### - ####

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Recurring Rate *

$ Dollars

Bookkeeping rates will be auto debited from your bank account every:

	Weekly	Bi-Monthly	Monthly
Bookkeeping Package

	1st of the Month	15th of the Month	Each Week
Auto Debited on:

Bank Account Name *

Name on Account *

Account # *

Routing # *

I Agree *

Contract terms require a 6 month contract period from the start of services. After the 90 day contract period has been fulfilled, termination of this contract requires a 60 days written notice by either party.

I authorize Easie Bookkeeping to debit my Bank Account provided on a recurring basis in the amount of my bookkeeping rate.

I authorize Easie Bookkeeping and their Independent Bookkeepers to access my company bank account(s) and/or credit card(s) and loan(s) for financial bookkeeping purposes.

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