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TRUCK RENTAL & LEASING107 WE Drive, Prestonsburg KY 416531-800-394-8447Account Settlement Authorization FormWorldwide Equipment Leasing (WEL) now proudly offers three (3) convenience options of scheduling payment of your monthly account balances. Accounts now may be paid by automatic/reoccurring payment options; Credit card settlements (pre-authorized reserve amounts)ACH direct bank account settlementWire transfer – setup continuous on line settlements via your financial institutionBenefits of Automatic/Reoccurring Payments:Peace of Mind / Convenience – Spend your time focusing on important aspects of your businessSavings – Eliminates postage & unnecessary late fee expenseCredit Reporting – Your account is reported “paid prompt” to all payment tracking services Please complete all necessary information:I _______________________________________________________hereby authorized & provide Worldwide Equipment Leasing, (Individual/company name)All rights to charge my credit card / bank account (ACH) in accordance to terms conditions of my (Full Service Lease and/or Rental agreements) in order to fully settle “all” outstanding invoices pertaining to my account immediately upon them being invoiced. I understand that invoice amounts will reflect both fixed cost + estimated amounts variable cost, taxes & mileage traveled during the agreed upon terms of said agreements & that periodically the account will either be credited or debited to correctness. Billing address_____________________________________________ Phone #___________________________________________City, State, Zip _____________________________________________ Email _____________________________________________Account type/Card Merchant: ___ Checking ___ Savings ___ MC ___ Visa ___ Discover___ Amex ___ other ___________________Account Name____________________________________________ CC Card # _________________________________________Bank Name_______________________________________________ Card CVS#_________________________________________Bank Routing # _____________________Acct # _________________ Expiration Date ____________________________________Note: ACH/credit card method requires card copy (front/back & properly signed) + copy named cardholder driver’s license.______________________________________________ __________________________________________________Authorized Signature DateWorldwide Equipment Leasing, Inc. - Wire Instructions Bank – JP Morgan Chase Bank Roundabout Plaza 1600 Division Street, STE 620 Nashville, TN 37203Contact: Dawn Johnson (404) – 926 – 2705Bank Acct #: 937456838 - ACH ABA #: 083000137 - Wire ABA #: 021000021I hereby agree & understand the following; this authorization will remain in effect until I cancel it in writing. I will notify Worldwide Equipment Leasing (WEL) in writing of any/all changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If my payment/invoice date falls on a weekend or holiday, the payment may be executed on the next business day. Because this is electronic transaction, funds will/may be charged/withdrawn from noted account as soon as the invoices are generated as outlined within the terms of the Lease/Rental agreement. In the event that any transaction should be rejected for any reasons, WEL may at its discretion attempt to process the charge again charge my account an additional $25 fee for each attempt. This fee will appear on my statements a separate transaction. I acknowledge that the origination of all transactions to my account must comply with the provisions of U.S. Law. I agree not do dispute this reoccurring billing with my financial institution so long as the transactions correspond to the terms indicated within my lease/rental agreement & this authorization form. Fixed Monthly $______________ Est. Variable $ _____________ Est. Taxes $ ____________Rental Reserve $ __________________Required Info – WEL Sales Internal Use Only ................
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