ACH Recurring Payment Authorization Form
Thank you for choosing Inque Media! Get started by filling out this form to set up your payment profile.
How Recurring Payments Work
• For recurring monthly services, you will receive an invoice via email, allowing ample time for review prior to processing payment..
• For project-based services, such as website or logo projects, payment is due as per the terms outlined in the proposal and your invoice, with the option for immediate collection.
• Hourly work will be collected monthly based on client requests and approvals.
• You will be charged the amount indicated on your invoice if different than the amount listed in the proposal.
• If you require a receipt, you must request this separately by emailing billing@inquemedia.com
Please complete the information below:
I am filling out this proposal as the authorized person for the company listed below:
I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Inque Media in writing of any changes in my account information or termination of this authorization at least 30 days prior to the next billing date. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above payment information is completed. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF), I understand that Inque Media may at its discretion attempt to process the charge again within 30 days as soon as 1 business day, and agree to an additional $25.00 charge for each attempt to return NSF which will be initiated as a separate transaction from the authorized recurring payment. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the prior or next business day. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law and cost listed in the proposal. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form or invoices. I hereby acknowledge that I have read and understood the above conditions.
