WP E-Signature by Approve Me - Sign Documents Using WordPress -

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 $49.50 cost of the program as advertised.
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.

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:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

October 6, 2025 9:53 am EST

ACH - Prospect Promo Uploaded by Brian Warden - brian@1040taxbiz.com IP 96.72.237.110

October 6, 2025 9:54 am EST

Admin Admin - admin@1040taxbiz.com added by Brian Warden - brian@1040taxbiz.com as a CC'd Recipient Ip: 204.156.181.61

November 18, 2025 5:50 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 5:50 pm EST

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