ACH Payment Authorization

Set up direct deposit for your revenue share payments

Carrier Information

Bank Account Information

Where to find your numbers:

Check diagram showing routing and account number locations

Verification Document

Upload ONE of the following: voided check (preferred), bank letter, or bank statement (first page).

Click to upload or drag and drop

JPG, PNG, GIF, or PDF (max 10MB)

* Verification document required

Authorization

By signing below, I authorize Guardian Visibility LLC to initiate ACH credit entries (deposits) to the above account. I understand:

  • • This is for deposits only—Guardian Visibility will not debit this account
  • • Payments are processed monthly, within 30 days after month end
  • • I must notify Guardian Visibility 15 business days before account changes
  • • This authorization remains until I provide written revocation

Questions? Call us at (406) 430-6100 or email payments@guardianviz.com