ACH Information Request Form.docx

211 E. 7th St. Suite 1000 Austin, TX 78701 855-777-4785 ach@dealerware.com

ach@dealerware.com mailto:ap@dealerware.com

ACH Request Form

To allow Dealerware to pay your monthly reimbursements via direct deposit ACH and to notify via email of the payment, please complete this form and return it to ach@dealerware.com. Dealerware will never debit your account, this is for credit only.

Dealership:

Address:

Banking Institution:

ABA (ACH) Routing Number:

Bank Account Number:

SWIFT Code (CAN only): Transit Number (CAN only):

Payment Notifications:

Email Address 1:

Email Address 2: _____________________________________________________________________________________________________

Please email the completed form to: ach@dealerware.com

Dealerware Inc. 211 E. 7th St, Suite 1000 Austin, TX 78701 1-855-777-4785 phone 1-512-727-0047 fax

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