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dish - <br />Dish Wireless L.L.C. <br />Authorization Agreement <br />for Automated Deposits & <br />Credits <br />I hereby authorize and request DISH Wireless L.L.C. ("Company") to make payment of any amounts owed to me by <br />initiating credit entries to my account at the Bank indicated below ('Bank"). I hereby authorize and request Bank to <br />accept any credit entries initiated by Company and to credit all such entries to my account without liability for the <br />correctness of the entries. <br />It is understood and agreed that I may terminate this agreement at any time upon three business days prior written <br />notice to Company or Bank. Notification to Company or Bank shall be effective upon receipt. <br />I understand and agree that if an erroneous credit is made to my account, that Company and Bank are authorized <br />to stop payment, reverse the entry or make any adjustments necessary to my account to correct the erroneous <br />entry. <br />DISH SG Site ID: <br />Landlord Entity Name: <br />Rent Payee Name: <br />(if different from <br />Landlord entity) <br />Signed: <br />Printed Signed Name: <br />Date: <br />Depositor Account Information <br />1. Attach a voided, pre-printed company check, deposit slip or letter from banking institution with the following <br />information: <br />• Account Name and Address <br />• Bank Name <br />• Bank Routing Number <br />• Bank Account Number <br />2. Email completed document to WirelessAPHelpDeskPDish. com OR mail to: <br />DISH Wireless L.L.C. <br />ATTN: Accounts Payable <br />9601 S. Meridian Blvd. <br />Englewood, CO 80112 <br />COMPANY/PERSONAL NAME 1102 <br />101 ANY ROAD <br />CITY, STATE 12345 DATE <br />ATTACH VOIDED CHECK HERE <br />Sample Bank NOT Wk H.8 NEGOTIABLE <br />8 <br />'W* R"i" SAMPLE -- VOID <br />