Loan/Invoice Number:



First Name:

Last Name:

Address:


City:

State:

Zip:

Email for receipt:

Amount (format 0.00):


Bank Account Type:

Bank Routing Number:

Bank Account Number:

Payment Data Systems, Inc. processes ACH transactions on behalf of Eastside Funding. By clicking ‘Submit’ below you agree to pay via this ACH Authorization. You acknowledge that you are voluntarily choosing to pay electronically. You understand and acknowledge that you may terminate the ACH Authorization by notifying us at support@paymentdata.com, subject: ACH Authorization Disputes, and in such time and manner as to afford us and your bank a reasonable opportunity to act on it.

Interest payments made after the 5th of each month may incur a late charge.

Refunds are handled on a case by case basis



  

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