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Star City Recycling

Impacting Our World - From Home

Debit Authorization Form

I (we) hereby authorize Star City Recycling to charge my (our) bank account indicated below for services rendered (including any late fees or unreturned equipment if applicable) or for any extra charges (TVs, microwaves, etc.) that I (we) authorize.

(Type of Account)
Checking
Savings

This authority is to remain in full force and effect until Star City Recycling has received written notification from me (or either account holder) of its termination at least ten (10) business days prior to the next payment period.

(Date)
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