ACH Payment Info

As an authorized signor on the banking account presented below and by completing and signing this form you give PETZ permission to debit or credit, as needed, your banking account.

This authorization is to remain in full force and effect until PETZ has received written notification from the authorized signor of its termination. I acknowledge that a Non‐Sufficient Funds (NSF) fee of $35 may be charged by PETZ to the Company for all returned payments

Company Name *

Account Type

Checking

Savings

Routing Number *

Account Number *

Authorized Signer *

Check Image

Agree

I have the authority to and agree to grant the use of this payment method for purchases or settlements from the PETZ platform.

Submit

All notifications, confirmations, and invoices will be sent to the Authorized Signer unless alternate information is provided for the Billing Contact. Future updates can be made through your account portal or by contacting your account manager.