ACH Payment Authorization

ACH Payment Authorization

Securely authorize direct deposit payments to your bank account via ACH transfer.

1
Contact
2
Bank Info
3
Authorize
4
Review

Your information

Enter your personal or business contact details.

Contact details

Bank account details

This account will be used to receive ACH payments. You can find your routing and account numbers on a check.

Pay to the order of
Your name
Bank name
Account type
••••••••• ••••••••••••
Account type

Authorization

Review the ACH authorization terms and sign to confirm.

ACH Authorization Agreement
Kolby AI, Inc. — ACH Payment Authorization

I authorize Kolby AI, Inc. to deposit payments owed to me via ACH transfer using the banking information provided in this form.

Authorization Terms: This authorization will remain in effect until I provide written notice to Kolby AI, Inc. to cancel or update my payment information. I certify that I am an authorized signer on the bank account provided and that all information submitted is accurate and complete.

Processing: ACH transfers typically process within 1–3 business days. I understand that if Kolby AI, Inc. deposits funds erroneously into my account, I authorize them to reverse the transaction.

Updates: To change banking information, I must submit a new ACH authorization form and provide at least 10 business days notice before the next scheduled payment.

Security: My banking information will be stored securely and used only for the purpose of issuing payments owed to me.
Electronic signature

By typing your name above, you authorize the ACH payment arrangement described above. This constitutes your legal electronic signature.

Review & submit

Confirm your ACH authorization details before submitting.

Authorization summary
Full name
Email
Bank name
Account type
Routing number
Account number
Authorized by
Date

A copy of this authorization will be sent to your email address. Please keep it for your records.

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ACH Authorized!

Your ACH payment authorization has been received.
A confirmation has been sent to your email.

Reference number