Client Pre-Funding Checklist (Banking Info)

Bank Authorization Form

I authorize Capital Finance LLC to initiate transaction entries to my Debit or Credit Card Account and/or to my Checking/Savings account indicated below:

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BANK ACCOUNT INFORMATION		DEBIT/CREDIT CARD INFORMATION		VERFICATION DOCUMENTS		SIGNATURE

Client Email Address on File *
N/A
Last 4 SSN *
N/A
By completing and signing this form you authorize Capital Finance LLC (‘Company’) to initiate entries to the Checking/Savings or to the Credit/Debit Card at the Financial Institution(s) listed. 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 48 hours prior to the payment being collected. This authority will remain in effect until Company is notified by you in writing to cancel in such time as to afford the Company and the Financial Institution a reasonable opportunity to act on it.
Signature *
N/A

E-Signature Field
Clear
Agent *
N/A
Capital Finance LLC
PO BOX 957869
DULUTH, GA 30095
info@gocapfinance.com
1-800-445-6156

Bank Authorization Form