Serving You Since 1946

ACH/Fax Check Application/Authorization

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This authority is to remain in effect until Farris Brothers, Inc. has received written notification from me of its termination affording Farris Brothers, Inc. and the named depository reasonable time to act upon the notification.

I (we) authorize authorize Farris Brothers, Inc. to debit my account at the depository financial institution above.

I (we) acknowledge the origination of ACH transactions to my (our) account must comply with provisions of U.S. law.