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ACTP Recurring Payment Authorization Form
Recurring Payment Authorization Form ---- You have opted to pay via the payment plan for Envision Coach Training’s ACTP Program. You authorize regularly scheduled charges to be automatically made to your Visa, MasterCard, American Express or Discover Card. You will be charged the amount of $1,500 per month for 6 months for a total of $9,000. The first payment will be made immediately and will secure your seat in the program. The following payment will be made one month later, the next a month after that, and so on for a total of six charges. A receipt for each payment will be emailed to you and the charges will appear on your bank statement from Envision Organization Services, Inc. You agree that no notification will be provided prior to the payments being collected. ---- I agree to the terms herein and I agree to notify Envision Organization Services, Inc. in writing of any changes in my account information at least 15 days prior to the next billing date. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that Envision Organization Services, Inc. may, at its discretion, attempt to process the charge again within 3 days, and agree to an additional $25 charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized recurring payment. I understand that, without exception, the payment transactions must be processing and completing as scheduled or I will not be able to participate in upcoming Modules. 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 credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company, so long as the transactions correspond to the terms indicated in this authorization form.