One Time Payment Authorization
Please complete this form to authorize EGNV, Inc. dba Vela Promos to make a one (1) time
debit to your checking or savings account. By submission of this form, you give us
permission to debit your account for the amount indicated upon receipt of this form. This is
permission for a single transaction only and does not provide authorization for any additional
unrelated debits or credits to your account.
I understand that because this is an electronic transaction, these funds may be withdrawn
from my account as soon as this form has been submitted or within three (3) business days.
In the case of the payment being rejected for Non-Sufficient Funds (NSF) I understand that
EGNV, Inc dba Vela Promos may, at its discretion, attempt to process the charge again
within 30 days, and I agree to an additional $75.00 fee for each transaction returned NSF.
A separate transaction from this authorized payment will be made to collect all incurred fees. I
acknowledge that the origination of ACH transactions to my account must comply with the
provisions of U.S. law. I will not dispute EGNV, Inc dba Vela Promos billing with my bank so
long as the transaction corresponds to the terms indicated in this agreement.