In exchange for products and/or services listed above the undersigned hereby authorizes SHIELD FUNDING to electronically draft via the Automated Clearing House system the amounts indicated above from the account identified above. This authority will continue until withdrawn in writing by the undersigned account holder The Undersigned hereby certifies that they are duly to execute this form on behalf of the above listed account holder Acknowledge that I am subject to a $25 reject fee if items are returned for insufficient funds.
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Sign below to authorize SHIELD FUNDING to make a one-time charge to your bank account listed above By signing this form, you give SHIELD FUNDING permission to debit your account for the amount indicated above. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits to your account. This payment is standard with every merchant cash advance agreement, which is considered a professional service fee.