United Truckers Services Inc 1385 Iris Drive SE - Conyers GA 30013 Pre-Authorized Withdrawal Authorization Form (ACH)
CUSTOMER INFORMATION.
I understand that if necessary, an adjusting debit or credit entry may be made to correct an error. I also authorize the Financial Institution named below to credit and/or debit my account for the correcting entries. I duly certify that I am an authorized signer of said account and have the right to enter into this agreement
ACCOUNT HOLDER INFORMATION. (Must be completely filled out)
This authority will remain in full force and effect until such time as "United Truckers Services" has received written notification from me that the draft revokation has been received. It is further provided that written notification of termination, by either party, shal be provided in such a time and manner as to afford either party reasonable opportunity to act on it
