About this template
The ACH Authorization Form is a critical tool for businesses, nonprofits, and service providers that need to collect recurring payments or facilitate direct deposits. By using this template, you allow your clients to securely provide their banking details and grant formal permission for automated fund transfers. This streamlines your accounts receivable process and eliminates the need for manual check processing or paper-based documentation.
Doc2Form makes it easy to deploy this professional authorization form in minutes. Whether you are a property manager collecting rent, a gym owner managing membership dues, or a consultant setting up retainer payments, this template ensures you capture all necessary routing and account information accurately. By moving this process to a digital format, you reduce administrative overhead and provide a cleaner, more professional experience for your clients, ensuring all terms and conditions are clearly acknowledged before any funds are transferred.
Key features
- Capture essential routing and account numbers securely.
- Define payment frequency and authorization terms clearly.
- Collect digital consent for recurring transactions.
- Mobile-optimized for easy client completion on any device.
- Seamlessly sync responses to Google Sheets for easy tracking.
Use cases
- Setting up recurring monthly rent or lease payments.
- Managing subscription-based service billing.
- Onboarding new employees for direct deposit payroll.
- Collecting one-time authorized electronic payments for invoices.
What this form collects
- Account Holder Full Name (Short answer)Enter the name exactly as it appears on your bank account.
- Email Address (Short answer)We will send a confirmation receipt to this address.
- Bank Name (Short answer)The name of the financial institution where the account is held.
- Account Type (Multiple choice)Select the type of account being used for these transactions.
- Routing Number (Short answer)The 9-digit number found on the bottom left of your checks.
- Account Number (Short answer)The account number associated with your bank account.
- Authorization Statement (Multiple choice)By checking below, you authorize us to initiate debit entries to your account for the agreed-upon amounts and frequency.
- Electronic Signature (Short answer)Please type your full name to serve as your electronic signature.
- Date of Authorization (Date)The date you are submitting this form.
FAQ
What is an ACH authorization form?
It is a legal document that provides a business with the necessary permission to withdraw funds from a customer's bank account via the Automated Clearing House (ACH) network.
Is this form secure?
Google Forms uses HTTPS encryption to protect data in transit. However, always ensure you are following your organization's internal data handling policies when collecting sensitive financial information.
Can I add my company logo to this form?
Yes, you can easily customize the header of your Google Form with your company logo and brand colors to build trust with your clients.
How do I process the payments after receiving the form?
Once you have the authorization, you will input the provided account details into your bank's portal or your chosen payment processing software to initiate the transfer.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.