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Direct Payment Authorization

Authorization for Monthly Draft

I (we) hereby authorize the Northwest Douglas County Chamber and Economic Development Corporation, hereinafter called (NWDCCEDC), to initiate charges to my (our) credit card indicated below. The debits/charges will occur on the 15th of each month, or the following business day if the 15th falls on a holiday or weekend.
In the event the account does not have sufficient funds, the following month the account will be debited/charges for two months, plus a $30 transaction fee. In the event the account has insufficient funds twice in a 12 month period or has been closed, the account will be deemed in default and the remaining balance for the annual membership becomes due immediately. This authorization shall remain in effect until NWDCCEDC receives a 30-day written notification from member of notifying NWDCCEDC of its termination of membership. Membership is on an annual basis.
If the termination occurs before 12 payments have been completed in that membership year, the remaining balance becomes due immediately.
I authorize NWDCCEDC to debit/charge my account for any fees incurred by NWDCCEDC as a result of delinquency.