ACH DebitsACH Debits Step 1 of 3 33% Select an option to continue(Required) New Participant Financial Institution and/or Account # Cancel Participation Account Authorization Type Fixed Amount and Date Variable Amount and Date Fixed Amount and Date Account AuthorizationI (we) hereby authorize Greenberg Fruit Company, (the "Company") to initiate debit entries and if necessary, initiate credit correction or adjustment entries to my (our) account at the financial institution indicated below. I (we) understand that should the regularly scheduled debit date fall on a weekend or federal holidy, the debit shall occur on the following banking date. I agree.Variable Amount and Date Account AuthorizationI (we) hereby authorize Greenberg Fruit Company, (the "Company") to initiate debit entries and if necessary, initiate credit correction or adjustment entries to my (our) account at the financial institution indicated below. I (we) understand that should the regularly scheduled debit amount vary above the set range, we will receive written notification from the COmpany of the new amount no later than ten (10) calendar days before the scheduled transfer date. If the scheduled date of the debit changes (other than for a weekend or federal holiday when the debit shall occur on the following banking date), I (we) will receive written notice from the Company no later than seven (7) calendar days before the new scheduled transfer date. I agree. Please attach a voided check or financial institution verification letter for account verification Drop files here or Select files Max. file size: 50 MB. Account Type Checking Savings Depository Financial InstitutionBranchAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Amount / Range to DebitDebit Date MM slash DD slash YYYY Recurrence (select one) One Time Only Weekly Monthly Quarterly Semi-Annual Annually Transit Routing NumberAccount NumberWithdrawal ConsentThis authority is to remain in full force and effect until the Company has received written notification from me (either of us) of its termination in such a time and manner as to afford the Company and the Depository Institution a reasonable opportunity to act on it. I agree.Company / Location NameAuthorized Signee First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code SignatureDate MM slash DD slash YYYY