Authorization Agreement Fortis, LLC D/B/A CrossFit Alabaster AUTHORIZATION AGREEMENTforDIRECT PAYMENT I hereby authorize Fortis, LLC D/B/A CrossFit Alabaster, hereinafter called COMPANY, to initiate debit entries to my Checking Account indicated below at the depository financial institution named below, hereinafter called DEPOSITORY, and to debit the same to such account. I acknowledge that the origination of Automated Clearing House (ACH) transactions to my account must comply with the provisions of U.S. law. In the event the draft is rejected and returned to Fortis, LLC by my bank for any reason (insufficient funds, account closed, etc.), I accept responsibility to remit payment to Fortis, LLC in a timely manner upon notification, and will also be subject to a returned payment fee of $30.Depository Name* Routing/Transit Number* Appears on the bottom of your checks.Account Number* Appears on the bottom of your checks.This authorization is to remain in full force and effect until Fortic, LLC has received written notification from me of its termination in such time and in such manner as to afford Fortis, LLC and DEPOSITORY a reasonable opportunity to act on it.Consent* I agree to this authorization for direct payment.Signature* Reset signature Signature locked. Reset to sign again Your Name* First Last NameThis field is for validation purposes and should be left unchanged.
