Recurring Payment Authorization Form
Schedule your payment to be automatically deducted from your bank account (via Debit Card), or charged to your Visa, MasterCard, American Express or Discover Card. Just complete and sign this form to get started!
Recurring Payments Will Make Your Life Easier:
It’s convenient (saving you time and postage)
Your payment is always on time (even if you’re out of town), eliminating late charges
Here’s How Recurring Payments Work:
You authorize regularly scheduled charges to your checking/savings account or credit card. You will be charged the amount indicated below each billing period. A receipt for each payment will be emailed to you and the charge will appear on your bank statement. You agree that no prior- notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.
I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Nautilus Aquatics in writing of any changes in my account information or termination of this authorization at least 15 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. In the case of a transaction being declined I understand thatNautilus Aquatics may attempt to process the charge again within 3 days, and if it continues to be declined will immediately make other payment arrangements. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.
I authorize Nautilus Aquatics to charge the credit card indicated
I wish to have payments drafted every month on the: