DO NOT place your company name here as the signature or the check may be rejected.
For joint accounts use only the SIGNER's name here.

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Transaction Terms

By placing my checking account information on this form I am requesting a payment be made using this account for the amount listed, made payable to the company listed. I agree to hold harmless Green By Phone e-check processing for any incomplete or incorrect data I may have entered. I understand that Green By Phonee-check processing is only a third party to this transaction and has no business interest besides processing e-checks on behalf of both the buyer and seller. I agree to hold harmless Green By Phone for any business involving myself, or my company, or the seller to whom I am paying this check. Once I press the Submit Payment button below my checking account will be debited for the amount listed above.  

I agree with these "Transaction Terms"