Recurring Payment Authorization Agreement

Make your payments electronically. No more handwritten checks, no more late fees. Direct debit your account with a pre-authorized recurring credit card transaction! To apply, follow the steps below:

In this Agreement, the term “Firm” shall mean The McShane Firm, LLC
By signing below, I hereby agree to the terms and conditions of this authorization agreement as follows: As the Debtor, I hereby authorize The Firm to electronically deduct the periodic installments authorized in the “Fee Agreement” previously executed for payment of the account at The McShane Firm, LLC, and to initiate credit entries in the event of erroneous charges. I hereby authorize the Financial Institution indicated below to accept and post these transactions to my account, shown below.
I authorize The Firm to adjust said transactions to reflect any charges authorized in the ‘Fee Agreement.”
In the event that my Financial Institution or account number changes, I acknowledge that 7 days advance notice must be given to The Firm before the changes take effect.

I understand and acknowledge that I have received a payment schedule with the due dates, amounts of future withdrawals, and applicable fees. I will retain the payment schedule for future reference since The Firm will not send out monthly notifications.

This authorization will remain in effect until I provide notice to The Firm of its termination. I understand that, in the event, I decide to terminate this payment method, I must advise The Firm at least 7 days prior to the installment due date. In the event that I do terminate this meth-od, I understand that I continue to be obligated to make the current payment due as outlined on the payment schedule.

In the event that this enrollment occurs after the inception of the “Fee Agreement”, we will debit your account the amount reflected on your “Fee Agreement”, as long as we receive the authorization form at least 2 days prior to the current due date.

I understand that if my financial institution does not honor any payment, an NSF fee will be assessed as outlined in the “Fee Agreement” in addition to the balance due on the account. In addition, your bank may charge a fee in that occurrence. I understand that if my financial intuition does not honor this debit request on the due date, I authorize the debit to be resubmitted until it is honored.

Clear Signature