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ACH Authorization Form

I (we) authorize Alpha-Omega Miracle Home (“COMPANY”) to electronically debit my (our) account (and, if necessary, electronically credit my (our) account to correct erroneous debits) as follows:

Account Information
Contact Information
Please Read and Sign Below

I (we) understand that this authorization will remain in full force and effect until I (we) notify COMPANY in writing, that I (we) wish to revoke this authorization. I (we) understand that COMPANY requires at least 4 weeks prior notice in order to cancel this authorization.

If the payment is rejected due to Non Sufficient Funds (NSF), I understand that COMPANY may attempt to process the transaction again within 30 days, and I agree to an additional $35 charge for each attempt that is returned due to NSF, which will be initiated as a separate transaction from the authorized payment.

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