We offer Electronic Account Debit for your convenience.   If you would like to take advantage of this payment method, please print and fill out the form below then mail or fax it back to us.

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You may switch payment methods at anytime.   You also may choose to do a one-time debit to your account or have your account debited automatically.   Please feel free to contact us at 800-869-0922 if you have any questions concerning this new method of payment.   Please include a voided check with this form.

Our mailing address is:	Our fax number is:
NetOne Communications, Inc.      2186 US 10      Sears, MI  49679	1-231-734-6395

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AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS (ACH DEBITS)

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Name ______________________________		Username __________________________
I (we) hereby authorize ___________________________________, hereinafter called NetOne Communications, Inc., to initiate debit entries to my (our) Checking Account / Savings Account (circle one) indicated below at the depository financial institution named below, and to debit the same to such account.   I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.
Depository Name ___________________		Branch ____________________________
City ______________________________		State __________	Zip ____________
Routing Number ____________________		Account Number ____________________
This authorization is to remain in full force and effect until NetOne Communications, Inc. has received written notification from me (or either of us) of its termination in such time and in such manner as to afford NetOne Communications, Inc. and Depository a reasonable opportunity to act on it.
Name(s) ___________________________		Username __________________________
(Please Print)
Date_______________________________		Signature__________________________