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AUTHORIZATION TO DO AUTOMATIC CHECK DRAFTING

Company Name:_________________________
Phone Number:_________________________
Name On check:_________________________
Bank Name:____________________________
Bank Phone Number:_____________________

I authorize 1access.net to use automatic check drafting as the
method of payment for my services through their company. I realize
that no signature is needed on these checks and that if I dispute a
charge through my bank that this will constitute a breach of contract
and result in immediate deactivation of my reseller ID.

1access.net customer please initial the following.

____ - please use Check Drafting for my method of payment.

I have included a blank voided check along with the signed copy
of this automatic check authorization form


Signature ____________________________ Date _____________

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INCLUDE PHOTO COPY OF CHECK BELOW THIS LINE

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