Direct Deposit / Zelle Payment Authorization Form

SPEARHEAD FREIGHT SOLUTIONS

Direct Deposit / Zelle Payment Authorization Form

I authorize Spearhead Freight Solutions to remit payments for services rendered by Direct Deposit (ACH) or Zelle using the information provided below. I understand it is my responsibility to notify Spearhead Freight Solutions immediately of any changes to my payment information.

Carrier/Business Name:

Owner Name:

Phone

Mailing Address:

City/State/ZIP:

Select Preferred Payment Method

Direct Deposit (ACH)

Zelle

Direct Deposit Information

Bank Name:

Account Holder Name:

Routing Number:

Account Number:

Account Type:

Checkings

Savings

Zelle Information

Zelle Email:

Zelle Mobile Number:

Authorization

I certify that the information provided is accurate and authorize Spearhead Freight Solutions to deposit payments electronically. I understand this authorization remains in effect until I submit written notice of cancellation or change.

Authorized Signature:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Printed Name:

Date:

SPEARHEAD FREIGHT SOLUTIONS

Direct Deposit / Zelle Payment Authorization Form

Carrier/Business Name:

Owner Name:

Phone

Mailing Address:

City/State/ZIP:

Select Preferred Payment Method

Direct Deposit (ACH)

Zelle

Direct Deposit Information

Bank Name:

Account Holder Name:

Routing Number:

Account Number:

Account Type:

Checkings

Savings

Zelle Information

Zelle Email:

Zelle Mobile Number:

Authorization

Authorized Signature:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Printed Name:

Date: