Recurring Billing and Payment Forms

Name*

Company*

Email (where invoices and receipts will be sent)*

Please select from the payment options below. If you select the credit card payment option, there will be a 3% credit card processing fee added to the sum total of your monthly charges. We recommend the secure ACH payment option, which requires no additional processing fees.

ACH Transfer: I would like to provide my bank account information below for a secure ACH transfer.

ACH Transfer: Use my bank account already on file with Savy.

ACH Transfer: I would prefer to provide my bank account information over the phone, instead of the secure form below.

CC: I would like to provide my credit card information on the secure form below.

CC: Use my credit card already on file with Savy.

CC: I would prefer to provide my credit card and billing information over the phone, instead of the secure form below.

Bank Account Info

1) Please enter your bank account information below, including the exact name that is associated with the bank account.

Account Type

Name

Account Number

Routing Number

ACH Authorization*

I authorize Savy to electronically debit my bank account for MONTHLY RECURRING CHARGES. Beginning with the date of this approval and ending upon written cancellation.

Credit Card Info

1) The name on card, address, city, state, and zip code fields all need to match those items on your payment card statement.
2) The security code is also known as the CSV code and is the 3-digit number found on the back of your payment card.

Name on Card

Address

City

State

Zip

Type (We accept VISA, MasterCard, Discover)

Card Number

Expiration Date

Security Code

Credit Card Authorization*

I authorize Savy to charge my credit card for MONTHLY RECURRING CHARGES. Beginning with the date of this approval and ending upon written cancellation.

Credit Card Processing Fee*

I authorize Savy to add a 3% credit card processing fee to the sum total of my monthly charges.

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