Updated Credit / Debit Card or Bank Information Sheet

Please complete this form to help us ensure that your payments are made timely to avoid any fees or delays in your case.

Name Of Cardholder Name Of Cardholder First Last
Email Address Of Cardholder
Billing Address Of Cardholder Billing Address Of Cardholder
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
PAYMENT METHOD UPDATE - Credit / Debit or Bank Account Drafts

ONLY complete ONE of the payment methods below
Credit / Debit Card Account Info
Credit / Debit Card Account Number
Expiration Date Of Credit or Debit Card
Security / CVC Code From Credit Or Debit Card
Bank Account Information (If Bank Drafts Are Preferred)
Bank Name
Bank Account Number
Bank Routing Number
Signature and Authorization Section

Please Sign Below To Submit This Form And Authorize This Information As Your Desired Payment Method For All Whitewood Tax Solutions Fees
By signing below, you attest that you are the account holder of the banking information provided and/or you have permission from the account holder to use this account for your tax matters. Furthermore, you understand that Whitewood Solutions cannot be held liable or responsible for any errors or fees associated with this account. It is your responsibility to keep the proper funds in the account to avoid any issues.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.