Direct Deposit Authorization (ACH)
ACH=Automated Clearing House
Name
*
First Name
Last Name
Email
*
example@example.com
Name(s) on Bank Account (business name if used)
*
Routing Number
*
must be 9 numbers - no spaces
Account Number
*
must be 9-12 numbers - no spaces
Bank Name
*
Bank Branch
*
City, State
Type of Bank Account
*
Personal Checking
Personal Savings
Business Checking
Business Savings
Other
Bank Phone Number
-
Area Code
Phone Number
Authorization Agreement for Direct Deposit
*
I authorize OCEANWIDE TRAVEL SERVICES LLC to withdraw funds each month equal to my monthly invoice amount. This authorization is to remain in force until the company receives my termination notice.
Date
*
/
Month
/
Day
Year
Date
Signature
*
Submit
Should be Empty: