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I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. DEPOSITORY NAME ACCOUNT NUMBER AT DEPOSITORY DEPOSITORY ROUTING TRANSIT NUMBER DEPOSITORY CITY AND STATE Authorized signature Date PLEASE KEEP A COPY OF THE AUTHORIZATION. 4900 Hwy 169 N Ste 205 New Hope MN 55428 Phone 888 874-7579 Fax 763 559-7549 DEALER ACH FORM Instructions Complete and sign the form and fax or mail with a copy of a voided check. DEALERSHIP NAME DEALERSHIP...

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