[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-283762-105":53,"doc-detail-283762-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","payment-authorization-form","Payment Authorization Form","","Payment Authorization Form for File & ServeXpress to collect outstanding balances via bank withdrawal (ACH) or credit card. The form records client ID and invoice information, authorizes one-time payment for unpaid invoices or recurring monthly drafts on/after the 15th. It collects billing contact details and bank or credit card data, including required voided check copy, card number, expiration date, and CCV. It also states draft terms, processing fee for card payments, and NSF fee handling, with signature and date.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/payment-authorization-form/283762/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/payment-authorization-form/283762.png","ImageObject",442,249,{"name":88,"@type":89},"Mali","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-29","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",19,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What payment options does the form provide?","Question",{"text":109,"@type":110},"It offers a one-time transaction for unpaid invoices, or a recurring monthly transaction on or after the 15th for open monthly invoice amounts.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What bank documentation is required for ACH payments?",{"text":114,"@type":110},"A copy of a voided check is required.",{"name":116,"@type":107,"acceptedAnswer":117},"What fees and penalties are described in the form?",{"text":118,"@type":110},"Credit card payments incur a 4.5% processing fee, and returned ACH transactions for NSF are subject to a $35.00 NSF fee, with additional charges for subsequent attempts within 30 days.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},283762,1791540821,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":4},2336475104362,"https://ap-avatar.wpscdn.com/avatar/22000c4c46a41b752dd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786595829695023868","4347 W. Northwest Hwy, Suite 130-280 Dallas, TX 75220  \nTel: (888) 529-7587  \nPAYMENT AUTHORIZATION FORM  \nPlease fill out the information below and submit [this form to ](this form to invoicing@fileandserve.com:)[invoicing@fileandserve.com](this form to invoicing@fileandserve.com:)[:](this form to invoicing@fileandserve.com:)  \nClient ID \\#:   Ammount:   Invoice \\#:    \nI   hereby authorize File & ServeXpress to withdraw payment from my bank account to clear the balance that is due on my File & ServeXpress account.  \nPlease fill check one  \nAs a one-time transaction for unpaid invoices with File & ServeXpress  \nAs a recurring monthly transaction on or after the 15 each month for open monthly invoice amount.  \n*By electing this option I understand that any open invoices will be resolved as a one-time payment to bring the account current.  \nSubsequent payments will resume as stated above.  \nBilling Address:   City:   State:   Zip:    \nPhone Number:   Email Address:    \nBANK INFORMATION  \n(COPY OF VOIDED CHECK REQUIRED)  \nChecking Savings  \nName on Acct:   Bank Name:   Account Number:   Routing Number:   Bank City/State:    \nCREDIT CARD INFORMATION  \nVisa MasterCard Amex Discover  \nCardholder Name:   Card Number:   Expiration Date:    \nCCV:    \nSignature:   Date:    \nBy signing this form, I agree and understand authorization for auto drafts will remain in effect unless File & ServeXpress is notified in writing to cease payment drafts 15 days prior to the next billing date. All payments will be processed on or after the date signed above. Credit Card payments will incur a 4.5% processing fee to be added at the time of the charge. Returned ACH transactions for Non-Sufficient Funds (NSF) are subject to a $35.00 NSF fee and subsequent efforts within 30 days will incur an additional $10.00 charge for each attempt. I certify I am an authorized user of the credit card/bank account and understand this document will be used to verify disputed transactions.  \n© 2022 File & ServeXpress. All rights reserved. CC_Payment_Form_V4","cbCaipIdozeoIZXZ","https://ap.wps.com/l/cbCaipIdozeoIZXZ","pdf",434354,"English","# Payment Authorization Form\n## Authorization Options\n## Billing Details and Contact Information\n## Bank Information\n## Credit Card Information\n## Fees, Terms, and Signature","[{\"question\":\"What payment options does the form provide?\",\"answer\":\"It offers a one-time transaction for unpaid invoices, or a recurring monthly transaction on or after the 15th for open monthly invoice amounts.\"},{\"question\":\"What bank documentation is required for ACH payments?\",\"answer\":\"A copy of a voided check is required.\"},{\"question\":\"What fees and penalties are described in the form?\",\"answer\":\"Credit card payments incur a 4.5% processing fee, and returned ACH transactions for NSF are subject to a $35.00 NSF fee, with additional charges for subsequent attempts within 30 days.\"}]","Payment Authorization Form | PDF",1789618917]