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:

  1. For the purpose of paying the initial $699 cost of the program as advertised.
  2. 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:

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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Signature Certificate
Document name: ACH - Premium
lock iconUnique Document ID: c84fe417359d9b7adad1c65a5bde87806fe3814e
Timestamp Audit
May 16, 2024 4:53 pm ESTACH - Premium Uploaded by Brian Warden - brian@1040taxbiz.com IP 204.156.181.60
May 16, 2024 4:59 pm ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 17, 2024 9:26 am ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 17, 2024 11:00 am ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 17, 2024 11:05 am ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 17, 2024 11:06 am ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 17, 2024 11:28 am ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
May 20, 2024 9:55 am EST Document owner antonio@1040taxbiz.com has handed over this document to brian@1040taxbiz.com 2024-05-20 09:55:53 - 96.72.237.110
May 20, 2024 9:55 am ESTBrian Warden - brian@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
June 4, 2024 4:35 pm EST Document owner brian@1040taxbiz.com has handed over this document to antonio@1040taxbiz.com 2024-06-04 16:35:25 - 204.156.181.55
June 4, 2024 4:35 pm ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 204.156.181.55
June 4, 2024 4:46 pm ESTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110
June 5, 2024 2:52 pm EST Document owner admin@1040taxbiz.com has handed over this document to brian@1040taxbiz.com 2024-06-05 14:52:08 - 71.129.152.216
June 5, 2024 2:52 pm ESTBrian Warden - brian@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 71.129.152.216
Audit trial Qr code
This audit trail report provides a detailed record of the online activity and events recorded for this document.
https://1040taxbiz.com/
Audit Trail Serial# dabdce59836c80a5ab002fb118de45e5