ACH Authorization Form All information is required Company Authorized to Debit/Credit Account: CorTech, LLC 901 Abernathy Road, Suite 100 Atlanta, GA 30328 Phone: 770-671-0444 Fax: 678-990-9304 Email: payroll cor-tech-2026

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The document is an ACH Authorization Form for CorTech, LLC, allowing the company to initiate credit and debit entries to an account holder's checking or savings account at Community & Southern Bank. It requires the account holder's information and authorization, which remains effective until terminated by written notice.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Account Holder Information. Fill in your name, address, phone number, city, state, and zip code accurately.
Next, provide your BANK information. Specify whether you are using a CHECKING or SAVINGS account and ensure that the bank details are correct.
In the AUTHORIZATION section, read the statement carefully. By signing this form, you authorize CorTech to process credit and debit entries as specified.
Complete the Employee Name and Date fields. Finally, sign the form to validate your authorization.
Don’t forget to attach a voided check to verify your account details before submitting the form.

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