ACH Online Authorization Form

I authorize Roofer's Supply Inc., to set up an online ACH account:

Please upload an image of a cancelled check below for bank routing and account number information.

Upon approval of this authorization form, Roofer's Supply Inc., may electronically debit your checking account for the full amount authorized.  Should the debit be returned unpaid by your bank, the full authorized amount plus a $35 returned item check fee may be both immediately debited from your account.

RETURN VIA EMAIL TO THE CREDIT DEPARTMENT AT: ar@rsirooferssupply.com

If you have any questions, please contact the credit department at 832-447-1386.