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

## 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 <u>ach@dealerware.com.</u> 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: 
<u>_____________________________________________________________________________________________________</u>

Please email the completed form to: <u>ach@dealerware.com</u>

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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