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 Enter A Valid Credit Card Number:

Please Enter Credit Card Expiration Date:

 

Please Enter Credit Card Security Code: 

Please Enter Credit Card Billing Zip Code:

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.

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: ACH - Premium
lock iconUnique Document ID: 6204495e9d7da7feeca43d4f53b5811e68a89553
Timestamp Audit
May 16, 2024 4:53 pm EDTACH - Premium Uploaded by Antonio Alford - antonio@1040taxbiz.com IP 96.72.237.110
May 16, 2024 4:59 pm EDTBrian 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 EDTBrian 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 EDTBrian 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 EDTBrian 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 EDTBrian 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 EDTBrian Warden - brian@1040taxbiz.com added by Antonio Alford - antonio@1040taxbiz.com as a CC'd Recipient Ip: 96.72.237.110