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ACH Bank Debit Authorization

I authorize Mehdiani Corporation (DBA Mehdiani Financial Management) to debit the bank account below for the amount applicable to professional services rendered, consistent with the engagement letter or other agreed terms. I authorize charge at the time of service, product order, or agreed scheduled. This authorization remains in effect unless canceled in writing.

ACH Bank Debit Information

Account Type: Business CheckingBusiness SavingsPersonal CheckingPersonal Savings

Name on account:

Bank routing number:

Bank account number:

Phone number on file with bank:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

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November 18, 2019 9:36 am PDT

ACH Bank Debit Authorization Uploaded by Alan Mehdiani - alan@mehdiani.com IP 103.61.240.165