ACH PPD and TEL Authorization Scripts and Fact Sheets

ACH Debit Authorization

For

(Merchant Name)

I, (customer name) , authorize (merchant name) , to withdraw $xxx.xx on the ____ of each month for the next xx consecutive months. The first payment is authorized to be debited from my checking account on __/__/2024. I am providing the following checking account information for these payments (routing number) , (checking account) .

By signing this sheet and returning it I acknowledge and consent to this ACH debit authorization agreement.

_____________________________

Written (for PPD) ACH Debit Authorization Fact Sheet

1. Any authorization documentation obtained from the receiver must indicate if the authorization is for a single transaction, recurring transactions, or subsequent transactions;

2. The amount of the entry must always be disclosed;

3. The timing (including the start date) number, and frequency of entries must always be disclosed;

4. The receiver’s name or identity as well as the account to be debited must always be disclosed;

5. The date of the receiver’s authorization must be included;

6. A 7-10 calendar day notice is required for changes to date or amount;

7. Records of authorized transactions must be maintained for two years;

8. Language that instructs the Receiver how to revoke the authorization directly with the Originator. In the case of a single entry scheduled in advance, the right of the receiver to revoke the authorization must afford the originator a reasonable opportunity to act on the revocation prior to initiating the entry.           

Sample Script of a TEL Initiated ACH Debit Authorization

“Thank you for calling Merchant Name , this call is being recorded. I understand that you have called to authorize a one-time debit from your account. Please confirm your full name, routing number, account number.”

…

“Thank you for that information. Today, xx/xx/2024 you confirm that you authorize a one-time debit from your account ending in xxxx, on xx/xx/2024.”

…

“Thank you for confirming your payment, we will mail you a confirmation of this transaction. If you need to cancel the payment, please contact us at xxx-xxx-xxxx.”

Verbal ACH (for TEL) Debit Authorization Fact Sheet

1. TEL authorizations must be initiated by the customer and are generally restricted to one-time payments;

2. A separate and distinct oral authorization must be obtained from the consumer for each TEL entry to be initiated to the originator’s account;

3. TEL authorizations need to either be recorded by the receiver or the receiver must deliver a written summary of the TEL ACH authorization that includes the payment details. In either case, the recording or a copy of the written confirmation must be retained by the receiver for a minimum of two years;

4. Each TEL ACH authorization must include the explicit consent of the originator.

5. A separate and distinct oral authorization must be obtained from the consumer for each TEL entry to be initiated to the originator’s account;

6. You are required to give a seven-day notice for a change of date;

7. You are required to give a ten-day notice for a change of amount;

Disclaimer: The statements presented are not legal or business advice. The templates and fact sheet are provided to assist Payrix partners with understanding the framework for TEL and PPD ACH processes. For further information and guidance, please refer to http://nacha.org