Recurring Payment Agreement Form Name(Required) First Name Last Name By signing this agreement, you have authorized Kim D. Emery Bookkeeping to bill your bank account or credit card for your monthly dues (EFT, preauthorized check card or credit card charge) for a minimum of 1 month from the start date (here in after) referred to as “the term”). Your account will be billed on or shortly following the 1st or 15th of each month beginning:In order to cancel a monthly service, you must cancel in office or over the phone. Payment AuthorizationAs a convenience to me, I authorize my bank to make payments to Kim D. Emery Bookkeeping. I agree that treatment of such payment shall be the same as if it were signed personally by me. Payment shall be made via the following method: I understand that I am in full control of my account and I may cancel my Electronic Funds Kim D. Emery Bookkeeping. I understand that EFT is not compulsory as an extension of credit.ANY HOLDER OF THIS MONTHLY SERVICE AGREEMENT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICE OBTAINED WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY DEBTOR HEREUNDER. I have read the attached comprehensive list of all recurring monthly service plans offered for sale by Kim D. Emery Bookkeeping, and the respective price of each plan. I realize all the provided material will be honored by Kim D. Emery Bookkeeping and understand my right to not sign if there are any incomplete blanks, my right to cancel, and the Kim D. Emery Bookkeeping refund policy. I further realize I must obey the rules of Kim D. Emery Bookkeeping and Kim D. Emery Bookkeeping reserves the right to refund the prorated remainder of the current month payment and remove me from Kim D. Emery Bookkeeping if my actions violate the rules of Kim D. Emery Bookkeeping.BY SIGNING BELOW, BUYER/BUYERS ACKNOWLEDGE THEY HAVE READ AND GIVEN THE OPPORTUNITY TO RECEIVE A COMPLETE COPY OF THIS AGREEMENT. I Agree(Required) I have read and fully understand the cancellation policy and billing procedure.* Signature(Required)Date(Required) MM slash DD slash YYYY Send me a copy Send me a copy of the agreement Email
