Recurring ACH authorization form
Make a recurring ACH authorization form. Set the amount and schedule, then download it. No signup. This site does not upload what you type.
1Your business
Paying someone instead? Use the vendor ACH form for suppliers or the direct deposit form for employees. To give a client your bank details, use the ACH information form.
2Payment details
3Form options
4Download
Copies the authorization paragraphs as plain text, for a contract or an online sign-up page. They point to the payment details, the bank account and the date on the form, so show those next to them. Check with your bank before use. Using the wording online or by phone
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Recurring ACH authorization, US LetterRecurring ACH Payment Authorization
Use this form to let ____________________ collect regular payments from your bank account by ACH. Fill in each section, sign, and return the form to us.
Account holder
Bank account
Please attach a voided check, or a bank letter that shows the routing and account numbers.
Payment schedule
Authorization
I authorize ____________________ to collect recurring payments from the bank account named on this form by ACH debit (an electronic withdrawal). The amount, how often payments are collected, and the first payment date are shown under "Payment schedule" above. If a payment date falls on a weekend or bank holiday, the payment will be collected on the next business day. ____________________ may also credit the account to correct a payment collected in error.
This authorization stays in effect until I cancel it. To cancel, I must tell ____________________ in writing, at least 3 business days before the next scheduled payment.
I confirm that I own this bank account or am authorized to sign for it, and that the details on this form are correct. If this is a business account, the account holder agrees to be bound by the Nacha Operating Rules for these payments. ____________________ will give me a copy of this authorization to keep.
Free. No signup. This site does not upload your details.
How to use this recurring ACH authorization form
- Add your business details. The form names your business as the one allowed to collect the payments.
- Choose how the amount works. The same amount each time, an amount that varies up to a maximum, or the amount due on each invoice.
- Set the schedule. Pick how often, the first payment date, and when payments end. Leave a field empty to print a blank line. Add extra lines, such as a customer number, under Form options.
- Download and send. The customer fills in their bank details, signs and dates the form, and returns it.
- Give the customer a copy and keep the signed form.
What a recurring authorization must include
A recurring ACH payment authorization form needs everything a one-time form needs, plus the schedule.
| Element | On this form | Source |
|---|---|---|
| Says it is for recurring payments | The title and the first sentence of the authorization | Nacha |
| Amount, or how it is set | “Amount of each payment” under Payment schedule | Nacha |
| How often, and the start date | “How often” and “First payment date” | Nacha |
| When payments end | “Payments end”: on cancellation, on a date, or after a number of payments | Nacha |
| The account to be debited | The Bank account section | Nacha |
| How to cancel | The “To cancel” sentence with your notice period | Nacha |
| Signature and date | The signature row | Regulation E and Nacha |
The Nacha link opens Nacha’s page about its standards for authorizations. That page says every consumer debit authorization must hold a minimum set of details. It does not print the list. The list is in the Nacha Operating Rules.
The Regulation E link opens 12 CFR 1005.10. Its paragraph (b) says recurring payments from a consumer’s account need a writing that the consumer signs or similarly authenticates.
Other sentences on the form, and why they are there:
- Different amount sentence (printed when the amount can change): Regulation E, 12 CFR 1005.10(d), asks for written notice of the amount and date at least 10 days before a recurring payment that is for a different amount than the one before it. The business may offer the customer notice only when a payment is outside a set range. Nacha’s guide How ACH works lists a 10 calendar-day notice for a change of amount and a 7 calendar-day notice for a change of date.
- Weekend and holiday sentence: ACH payments settle only on banking days. See how long an ACH transfer takes. Nacha’s page How ACH payments work lists it as common practice that a bill payment due on a weekend or holiday is collected on the next business day.
- Correction sentence: Common practice, so a payment taken in error can be refunded to the same account. Not a rule.
- Returned payment fee sentence (optional): Regulation E, 12 CFR 1005.3(b)(3), asks for notice, with the amount, before a fee is collected electronically. State law may limit the fee.
- Copy sentence: Regulation E, 12 CFR 1005.10(b), says the person who gets the authorization must give the consumer a copy.
- Business account sentence: Nacha’s guide How ACH works says two businesses need an agreement, and both must be bound by the Nacha rules.
Which amount option to pick
| Option | Use it when | What you must do later |
|---|---|---|
| The same amount each time | Rent, memberships, fixed plans | Give 10 calendar days’ written notice before any change |
| Varies, up to a maximum | Utilities, usage-based bills | Give notice only when a payment is above the maximum |
| The amount due on each invoice | Accounts billed by invoice | Send the amount and date at least 10 calendar days before each payment |
Common mistakes and how to fix them
- No start date. The timing must include the start date. Fill it in or make sure the customer does.
- A “maximum” set far too high. The range has to be one the customer could expect. Set a realistic maximum.
- Carrying on after a cancellation. Once the customer cancels, stop. A payment taken after that can be returned as R07, authorization revoked.
- Retrying a failed payment with a fee added. A retried payment cannot be for more than the original amount. A returned payment fee is a separate matter. Check your state law and ask your bank first.
Sample recurring ACH authorization form (filled in)
This is what the form looks like once it is filled in. Yours will show your own business name.
Recurring ACH Payment Authorization
Please check the details below, then sign and return this form to Maple Street Fitness.
Account holder
Bank account
Please attach a voided check, or a bank letter that shows the routing and account numbers.
Payment schedule
This payment will appear on your bank statement as: MAPLE ST FITNESS
Authorization
I authorize Maple Street Fitness to collect recurring payments from the bank account named on this form by ACH debit (an electronic withdrawal). The amount, how often payments are collected, and the first payment date are shown under "Payment schedule" above. If a payment date falls on a weekend or bank holiday, the payment will be collected on the next business day. Maple Street Fitness may also credit the account to correct a payment collected in error.
This authorization stays in effect until I cancel it. To cancel, I must tell Maple Street Fitness in writing at [email protected], at least 3 business days before the next scheduled payment.
I confirm that I own this bank account or am authorized to sign for it, and that the details on this form are correct. If this is a business account, the account holder agrees to be bound by the Nacha Operating Rules for these payments. Maple Street Fitness will give me a copy of this authorization to keep.
Questions and answers
What is a recurring ACH authorization form?
A recurring ACH payment authorization form is a signed document that lets a business take payments from a customer's bank account on a regular schedule, such as monthly rent or a weekly membership fee. It states the amount or how it is set, how often payments are taken, the start date, and how the customer can cancel.
Does a recurring ACH authorization have to be in writing?
For a consumer's account, yes. Regulation E says recurring electronic transfers from a consumer's account may be authorized only by a writing that the consumer signs or similarly authenticates, and the consumer must get a copy. An electronic signature counts.
What if the payment amount changes?
Send the customer written notice of the new amount and the payment date at least 10 calendar days before the payment. Use the change notice letter. The customer can instead agree to be told only when a payment is above a set maximum. Choose "Varies, up to a maximum" in the builder to print that choice on the form.
What if I need to change the payment date?
Nacha rules ask for written notice of the new date at least 7 calendar days before the first payment it affects. A payment that moves because of a weekend or holiday does not count as a change of date. Use the change notice letter.
How does a customer cancel a recurring ACH payment?
The customer tells you in writing within the notice period printed on the form. A consumer can also ask their own bank to stop a payment, by giving the bank notice at least three business days before the scheduled date.
Is there a Spanish version of the form?
Yes. Under Form options, tick "Add a Spanish version as page 2". The download then has the English form on page 1 and the same form in Spanish on page 2. The person fills in and signs only one of them.
Sources
- 12 CFR 1005.10, Preauthorized transfers (Regulation E), Consumer Financial Protection Bureau
- Official interpretation of 12 CFR 1005.10, Consumer Financial Protection Bureau
- Meaningful Modernization (standards for authorizations), Nacha
- How ACH works (notice of changes to recurring debits), Nacha
- 12 CFR 1005.3(b)(3), fees for returned payments (Regulation E), Consumer Financial Protection Bureau
- How ACH payments work (payments due on a weekend or holiday), Nacha
General information, not legal or financial advice. Rules change and banks set their own requirements. Check with your bank before you act. ACH Forms is not affiliated with Nacha.