Why use Automatic Check Handling?

  1. More secure for you than mailing a check...helps prevent fraud and identity theft.
  2. Saves you money; no postage or check fees
  3. Saves you time; fill in the form once and you are done.
  4. Saves the environment. No resources are used in the production of checks, envelopes or stamps.
  5. No charge to you for this automated service


Street Address of Protected Premises: A value is required. Name of Company Initiating Payments:

Redwood Security Systems, Inc

My Bank's Name & Branch: A value is required. My Bank's City, State & Zip: A value is required.
My Bank's Routing Number
(see sample below)
A value is required.
My Bank Account No.:
(see sample below)
A value is required.
Amount of Each Quarterly Payment:
A value is required.
Approximate Date of First Automatic Payment: (Format: mm/dd/yy)
A value is required.
I hereby authorize Company and its bank, Bank of Marin ("Bank of Marin") to initiate withdrawals ("debits") from my Please make a selection. account ("My Bank Account") identified above at My Bank identified above through the Automated Clearing House system. These debits are to be processed beginning on the date indicated above. If this date, or the same day of the month during which a subsequent debit is to be processed, is not a banking day on which the debit can be processed, the debit should be processed on the banking day before or after the scheduled date, at Company's option. I also authorize Company to initiate deposits ("credits") to My Bank Account to correct any errors that may have been made with debits from My Bank Account. I authorize My Bank to process these debits from and credits to my Bank Account.
This authorization will remain effective until I give Company written notice to the contrary and Company has had a reasonable period of time to act on that notice. My revocation of Company's authority to initiate debits to My Bank Account will not affect Company's right to initiate credits to My Bank Account to correct or adjust a debit processed before my revocation of authority has become effective. Delivery of the executed ACH Document by facsimile or other electronic means is equally as effective and binding on you as delivery of an originally executed Document.

I Warrant to Company, Bank of Marin and My Bank that:

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Today's Date: (Format: mm/dd/yy)
A value is required.
My Full Name:
A value is required.
Full Name of Other Required Signer:
A value is required.