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I (we) hereby authorize Lee’s Tax City, LLC /dba: 1040TaxBiz to initiate ACH transactions to the banking institution and account named as indicated below for the purpose of tax preparation revenue transactions. This authorization is to remain in effect until 1040TaxBiz receives written notification of termination or change of account information.

The credit card will be charged for the following circumstances:

For the purpose of paying the initial $99.00 cost of the program as advertised.
The remaining balance of $400 will be added to the Client’s account statement. 1040 TaxBiz is authorized to deduct the remaining $400 from taxpayer funding until the balance is paid in full. Any outstanding balance must be paid no later than February 27, 2026, and will be collected using the payment method on file. If the balance cannot be collected, the Client’s portal and software access will be temporarily suspended until payment is received in full.
In the event of a "Return ACH" when 1040 TaxBiz initiates ACH debit for weekly EFiles fees, the credit card will serve as a backup method for payment.

All payments Are Non-Refundable after 14 days. Payment will be due at the time the agreement is completed.

Please Upload Clear Image Of The Front Of Credit Card:

Please Upload Clear Image Of The Back Of Credit Card:

Which Type Of Account:

Checking

Savings

Bank Name:

Please Enter Your Routing Number:

Please Enter Account Number:

I understand and agree that this authorization will remain in effect until I provide written notification of its cancellation. I further understand that this authorization will cover any and all transactions related to the aforementioned program, including but not limited to the initial payment, recurring fees, and any additional charges that may be incurred.

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Timestamp

Audit

October 10, 2025 11:17 am EST

ACH - Premium Deposit Uploaded by Brian Warden - brian@1040taxbiz.com IP 96.72.237.110

October 10, 2025 11:19 am EST

Admin Admin - admin@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 204.156.181.37

November 18, 2025 5:41 pm EST

Lisa Martin - Lisa@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110

November 18, 2025 5:41 pm EST

Brian Warden - brian@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110