Read carefully, then sign electronically below.
I, the undersigned, hereby authorize Franco Blueprint Inc. to charge the credit card or debit the bank account identified above for the amount(s) and on the schedule indicated in the "Payment arrangement" section of this form.
For ACH (bank debit) authorizations, I acknowledge that this authorization will remain in full force and effect until I notify Franco Blueprint Inc. in writing (via email to cfo@francoblueprint.com) of its termination, with sufficient notice to allow Franco Blueprint Inc. and my financial institution a reasonable opportunity to act on it. I understand that I have the right to dispute any unauthorized debit through my financial institution under the rules of NACHA.
For credit card authorizations, I certify that I am the authorized cardholder (or authorized agent thereof) and that the charges described herein represent valid obligations of the entity named in section 01.
I understand that this is an electronic record and that my electronic signature has the same legal force and effect as a handwritten signature, in accordance with the U.S. Electronic Signatures in Global and National Commerce Act (E-SIGN, 15 U.S.C. § 7001 et seq.) and applicable state law.
