By clicking "Send" below, I am choosing to allow Reliable Credit Association, Inc. to share the information contained in this One Time ACH Payment request with Reliable Credit Association, Inc. (WA), in accordance with Section II E. of the Privacy Statement. I have read and understand the Privacy Statement. I also consent to your delivering the information above to your originating depository financial institution in order to complete this requested One Time ACH Payment. I understand that depending upon when my One Time ACH Payment is processed, my account may not be debited until after the date I list above as the date I want my account debited. I will remember to deduct from my account the amount I wish to pay, listed above. I understand that you will charge me $15 per payment to use this One Time ACH Payment system. I warrant that I am your customer and I that I am legally entitled to authorize the debit entry described above. I understand also that if my debit is rejected by my financial institution or there are insufficient funds, you will charge me an NSF fee under my loan agreements or retail installment contract, as if I had delivered to you an NSF check. In addition, I may be assessed other charges by my financial institution. I will print out and retain one copy of this completed Web page before pressing send. |
