Company name is required
First name is required
Last name is required
Phone is required
Email is required
Bank name is required
Checking account # is required
Re-enter checking account # is required
Checking account #'s don't match
Routing # is required and must be 9 digits
Re-enter routing # is required and must be 9 digits
Routing #'s don't match
Terms and Conditions
Customer authorizes P-Fleet to initiate debit and/or credit entries to Customer's account at Customer's financial institution named above, relative to payment by Customer for products purchased from P-Fleet. Customer further authorizes the named financial institution to debit and/or credit Customer's account as set forth in this Agreement. Each entry initiated shall be accompanied by P-Fleet's invoice number and net invoice amount. All entries initiated under this Agreement shall be for properly supported charges due and owing P-Fleet. You are hereby authorized, as a convenience to me, to pay and charge my account electronically, provided there are sufficient collected funds in such account to pay the same upon presentation. This authorization will remain in effect until revoked by me in writing, and until you actually receive such notice. I agree that you shall be fully protected in honoring any such electronic debit. This Authorization Agreement allows P-Fleet to charge debits to this account at frequent intervals for varying amounts. It is acknowledged and accepted that the debits owed to P-Fleet will typically be paid on the due date or next business day. P-Fleet will notify us of any and all impending debits. The right to review any invoice before a debit is charged to our account is hereby relinquished. In the event a debit is shown to have been made erroneously, P-Fleet agrees to correct such error immediately.
You must accept the Terms and Conditions
By submitting this authorization, I represent and warrant that I am authorized to enter into this agreement on behalf of the Company. I certify that I have read in full our Terms & Conditions above, and have provided current, complete and accurate information..
This EFT Authorization has errors. Please complete the required fields above.
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