Authorization agreement for E-bill with Auto-Bank Draft

I hereby authorize Home Telecom hereinafter called COMPANY, to initiate debit entries, or such entries (debit or credit), which are necessary for corrections, to my indicated bank account. I further authorize the Financial Institution named below, to debit (or credit) the name to such account.

I understand that I am enrolling to receive my monthly statement via email and that my payment will automatically be drafted from my bank account each month. This authority is to remain in full force and effect until COMPANY has received written notification from me of its termination in such time and in such manner as to afford COMPANY a reasonable opportunity to act on it.

I would like to receive a confirmation contact once my order has been processed

Please sign below:

Erase signature Date:

FAQS

Q. Will I continue to get a bill?

A. Yes. Once enrolled, you will receive your bill via email each month.

Q. Is there any charge for this service?

A. No. There is no sign-up charge. If your bank charges for electronic transfers, normal charges apply.

Q. What day of the month will my payment be deducted from my bank account?

A. Your payment will be deducted from your account on the 1st, 10th, or 20th of each month depending on your billing cycle. If the date selected for your account falls on a weekend or holiday of any given month, your account will be drafted on the following business day.

Q. What happens if for any reason there isn't enough money in my account?

A. It would be handled by the bank just like an overdrawn "bounced" check.

Q. What should I do to sign up?

A. Please follow the steps above to enroll, or print this form then mail/deliver it to one of the Home Telecom retail centers.