ACH Authorization Form

This form authorizes Nortex Communications to withdraw funds each month equal to my monthly invoice amount. This authorization is to remain in force until the company receives my termination notice. For security purposes, I understand to complete ACH authorization, my bank routing, debit card or credit card information must be given to a Nortex Communications representative by calling 940-759-2251.

Mailing Address (if different from above)
Mailing Address (if different from above)
Recurring Automatic Payment from Checking Account
This field is for validation purposes and should be left unchanged.
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