FREEDOM FASTax Service
Guarantee of Payment Authorization
The purpose of the Guarantee of Payment Authorization is to insure payment where services are rendered before payment has been received.
Bank (Example: WaMu, B of A, Citibank, etc.)
Memo __________________ ___________________________________
Bank Routing Number (9 digits) Account Number Check number
:'123456789': (lower left corner) 7889024768 000"' 1001
For Tax Refunds and Authorization
Account Number (don't include check number)
If Payment Guarantee is by credit card, complete the following...
Otherwise, skip down to "I Agree" button and complete authorization.
Card Code: (3 digit code on back of card)
Print Name (Electronic Signature Authorization)