SunFlora, Inc.
Recurring ACH Payment Authorization
Authorization
You authorize regularly scheduled charges to your checking/savings account in the amount of each Sales Order placed. The charge will appear on your bank statement as an “ACH Debit”. You agree that no prior-notification for each charge will be provided.
I

,

authorize:

SunFlora, Inc to charge my bank account indicated below for the amount of each Sales Order placed, immediately after and on the day the order is placed. 

This payment is for Goods purchased on the https://getsunmed.com website.
Billing Information






Bank Routing Information

Routing and Account Number Example
Bank Details







I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify SunFlora, Inc to accounting@getsunmed.com in writing of any changes in my account information or termination of this authorization at least 10 days prior to the next Sales Order being placed. 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. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as a Sales Order is completed. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I agree that SunFlora, Inc. may at its discretion attempt to process the charge again within 2 days, and agree to an additional $100.00 charge for each attempted/returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this bank account and will not dispute these scheduled transactions with my bank; so long as the transactions correspond to the terms indicated in this authorization form.


(Account Holder's Full Name)

Please enter the correct account and routing numbers before submitting information. Thank you!