Orange County NC Website
DocuSign Envelope ID:F8A6106B-387F-4148-B9F8-4D7937C08E11 <br /> 1,t <br /> Fetch Networks,LLC Support/Sales <br /> 2500 Regency Parkway Phone Number:866-568-8598 <br /> Cary,NC 27518 <br /> AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS <br /> Direct Debit(ACH)&Credit Card <br /> Company Name: Billing Address: <br /> Phone: <br /> Email: <br /> Subscription Services Payment Options: <br /> Monthly Payments 30.00 <br /> Annual Payments You Save per Month(2.5%) <br /> Full Term One-Time Payment You Save per Month(2.5%) <br /> Total One-Time Fees: 450.00 <br /> (above amounts exclude applicable taxes and fees) <br /> I(we)hereby authorize Fetch Networks,LLC,to initiate debit entries to my(our) <br /> Please Select One Payment Method: <br /> Bank via ACH: Credit Card: <br /> (select one) Checking Savings (select one) Visa Mastercard <br /> American Express Discover <br /> Bank Name: Card Number: <br /> Routing Number: Expiration Date: <br /> Account Number: Security Code: <br /> Cardholder Name: <br /> Cardholder Street: <br /> Cardholder City: <br /> Cardholder State: Cardholder Zip: <br /> INVe authorize Fetch Networks, LLC("Fetch")to begin deductions as per my/our instructions for regular recurring payments and/or one-time payments from <br /> time to time,for payment of all charges arising under my/our Fetch account(s) including applicable taxes and fees. Regular recurring payments for the full <br /> amount of services delivered will be debited/charged to my/our specified accounts each payment cycle.This authority is to remain in effect for the duration of <br /> the Service Term as defined in the signed Services Order Form or until Fetch has received written notification from me/us of termination.This notification must <br /> be received at least fifteen(15)days before the next debit is scheduled at the address provided below. <br /> Signature: Date: <br />