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This was last modified on DECEMBER 19, 2022.

I authorize Payliance and/or its affiliates and subsidiaries (“Merchant”) to initiate the one-time payment(s) for the amount(s) indicated to the bank account(s) and/or Payment Card(s) I am selecting. I understand the withdrawal(s) from my bank account(s) and/or charge(s) to my Payment Card(s) will take place on or after today’s date.

I certify that I am an owner or authorized signer for the selected bank account(s) and/or Payment Card(s). I authorize the corresponding financial institution(s) to honor the withdrawals and/or charge(s).

I acknowledge it is my responsibility to have sufficient available funds for the selected bank account(s) and/or Payment Card(s) to cover the payment(s). 

I understand that a scheduled One-time bank payment can be cancelled by 5PM EST at least one business day prior to the date my payment(s) is scheduled to occur. To do so, go to Transactions by logging on to the mobile app.

I agree to receive information via SMS messages regarding one-time payments therefore I will maintain a current mobile phone number with Merchant and ensure that it is active and capable of receiving new SMS messages.

I have also read and agree to the Terms and Conditions.

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