ePayResources Affiliates Membership Application and Agreement.

We hereby make application for Affiliate membership in ePayResources.


Applicant recognizes and agrees that it (i) will be bound by, and comply with, the Bylaws of ePayResources as they may be in effect from time to time; (ii) will adhere to the ePayResources Code of Conduct as in effect from time to time and a copy of which is attached-here to; and (iii) will pay the membership dues for members as determined by the Board of Directors of ePayResources from time to time.


Click here to access ePayResources Code of Conduct. Submission of this membership application and agreement, is acknowledgement and acceptance of our code of conduct.

Address*
Describe your line of business

Required Contacts (individuals may be more than one contact type)

Additional contacts found on the next page.

Primary Contact (gets Nacha Rules Online Access Code)*
Billing Contact *
Operations Contact
Executive / CEO Contact
Audit / Compliance / Risk Contact

Additional Contacts (individuals may be more than one contact type)

Feel free to provide additional contacts to Membership@ePayResources.org if space not provided below.

Treasury / Cash Management Contact
IT / Information Security Contact
Marketing Contact

Membership Dues Structure


Fees are automatically renewed on January 1 of each year for Affiliate members unless written cancellation is received ninety days in advance. Fees are non-refundable once the current year is in force. ACH payments require the routing and transit number of your financial institution (or correspondent), a demand, savings, or general ledger account number, and your account name for proper authorization. Initial and minimum annual fees may also be paid via check.


**Membership dues structure is subject to change annually**

Please select a payment method:
Remit to the attention of: Katy Todora, AAP Manager - Accounting Services – 1999 Bryan St., Ste. 950, Dallas, TX 75201. Please direct billing questions to: ePayResources, 800.475.0585 Option 6, accountspayable@epayresources.org
VISA, Mastercard, or American Express

Agreement: ACH Authorization for CCD Transactions


This Agreement governs ACH transactions initiated by ePayResources to credit or charge the Company indicated below.  Both parties agree to be bound by NACHA Operating Rules as they pertain to all ACH transactions initiated by ePayResources that credit or debit the Company bank account listed below, and acknowledge that the origination of ACH transactions to the listed account must comply with provisions of U.S. law.


This Agreement provides authorization for individual or recurring CCD transactions to be initiated by ePayResources when individually authorized using the methods designated below.  This Agreement will remain in effect until Company cancels it in writing, or by email.  Both parties agree that this Agreement in conjunction with any of the designated methods constitutes authorization to debit Company’s business bank account, and Company agrees not to dispute any debits with its bank provided the transaction(s) correspond to the terms indicated in this Agreement. ePayResources reserves the right to cancel this agreement at any time.


Please complete the information below:

(Company)
Account Type*
This Bank Account is Enabled for ACH Transactions*
Individual Transaction or Recurring Schedule Authorization Methods*
(check all that apply)

I Authorize ePayResources to initiate ACH Debits and Credits to the bank account indicated above, provided each transaction is initiated according to the terms of this Agreement.

How would you like to sign this form?*
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Date/Time*
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I certify that I am an authorized representative of the Company indicated above and that I have the authority to enter into this Agreement on the Company’s behalf.  Company understands that this authorization will remain in effect until it is canceled in writing and agrees to notify ePayResources in writing at least 15 days in advance of any changes in its account information or termination of this authorization. Cancelling this payment authorization does not cancel your membership with ePayResources. Company understands that because these are electronic transactions, these funds may be withdrawn from its account as soon as the date an individual transaction is authorized, and that it will have limited time to report and dispute errors. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF), Company understands that ePayResources may at its discretion attempt to process the charge again within 30 days, and agrees to an additional $35 charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized payment. Company has certified that the above business bank account is enabled for ACH transactions, and agrees to reimburse ePayResources for all penalties and fees incurred as a result of Company’s bank rejecting ACH debits or credits as a result of the account not being properly configured for ACH transactions. Company acknowledges that the origination of ACH transactions to its account must comply with the provisions of U.S. law.

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