ACH PPD and TEL Authorization Scripts and Fact Sheets

I, (customer name) , authorize (merchant name) , to withdraw $xxx.xx on the ____ of each month for the next xx consecutive months. The first payment is authorized to be debited from my checking account on __/__/2024. I am providing the following checking account information for these payments (routing number) , (checking account) .

By signing this sheet and returning it I acknowledge and consent to this ACH debit authorization agreement.

_____________________________

Written (for PPD) ACH Debit Authorization Fact Sheet

1. Any authorization documentation obtained from the receiver must indicate if the authorization is for a single transaction, recurring transactions, or subsequent transactions;

2. The amount of the entry must always be disclosed;

3. The timing (including the start date) number, and frequency of entries must always be disclosed;

4. The receiver’s name or identity as well as the account to be debited must always be disclosed;

5. The date of the receiver’s authorization must be included;

6. A 7-10 calendar day notice is required for changes to date or amount;

7. Records of authorized transactions must be maintained for two years;

8. Language that instructs the Receiver how to revoke the authorization directly with the Originator. In the case of a single entry scheduled in advance, the right of the receiver to revoke the authorization must afford the originator a reasonable opportunity to act on the revocation prior to initiating the entry.           

“Thank you for calling Merchant Name , this call is being recorded. I understand that you have called to authorize a one-time debit from your account. Please confirm your full name, routing number, account number.”

…

“Thank you for that information. Today, xx/xx/2024 you confirm that you authorize a one-time debit from your account ending in xxxx, on xx/xx/2024.”

…

“Thank you for confirming your payment, we will mail you a confirmation of this transaction. If you need to cancel the payment, please contact us at xxx-xxx-xxxx.”

Verbal ACH (for TEL) Debit Authorization Fact Sheet

1. TEL authorizations must be initiated by the customer and are generally restricted to one-time payments;

2. A separate and distinct oral authorization must be obtained from the consumer for each TEL entry to be initiated to the originator’s account;

3. TEL authorizations need to either be recorded by the receiver or the receiver must deliver a written summary of the TEL ACH authorization that includes the payment details. In either case, the recording or a copy of the written confirmation must be retained by the receiver for a minimum of two years;

4. Each TEL ACH authorization must include the explicit consent of the originator.

5. A separate and distinct oral authorization must be obtained from the consumer for each TEL entry to be initiated to the originator’s account;

6. You are required to give a seven-day notice for a change of date;

7. You are required to give a ten-day notice for a change of amount;