I authorize TSB Software to debit the above payment of $ from my bank account listed above. I understand that this authorization will remain in full force and effect until I notify TSB Software by telephone that I wish to revoke this authorization. I understand that TSB Software requires notification prior to its submission to the Automated Clearing House Network in order to cancel this authorization.

By checking the box to the left, you are indicating that you give TSB Software your authorization to process the payments as outlined in the payment schedule above using the payment method listed above. To revoke your authorization you must contact TSB Software.