Payment Information

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify First Choice Insurance Group LLC, in writing, of any changes to my account, or my request to terminate this authorization at least ten (10) business days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH transaction being rejected for Non-Suffiedient Funds (NSF) I understand First Choice Insurance Group LLC may, at its discretion, attempt to process the charge again within five (5) days. I agree to an additional $25 charge for each attempt that is returned NSF, which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. Law. I certify that I am authorized user of bank account and will not dispute these scheduled transactions with my bank, so long as the transactions correspond to the terms indicated on this authorization form.