Free ACH authorization form
Download a free ACH authorization form template in PDF or Word, or fill one out online and print it.
An ACH authorization form is a signed record that gives a business permission to debit a customer's or vendor's bank account through the ACH network. While there's no official format, NACHA has specific requirements that must be followed. This includes clear authorization language, the amount and timing, a way to revoke, account details, and a signature. Businesses use it to collect from a customer or to authorize debits to a vendor's account.
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ACH debit authorization
Authorization for direct payment via ACH
Complete, sign, and return to the business named above
The undersigned company authorizes [BUSINESS NAME] ("Company") to electronically debit the account identified below at the financial institution named below, and, if necessary, to electronically credit that account to correct erroneous debits. The undersigned company agrees that ACH transactions under this authorization must comply with all applicable U.S. law and NACHA operating rules.
Payment terms
A single debit of [AMOUNT], initiated on or after [START DATE].
Account information
Account holder name
Financial institution
Routing number (9 digits)
Account number
Revocation
This authorization remains in effect until the undersigned company revokes it by the following method: Written notice to the Company at the address or email it provides, at least 10 business days before the next scheduled debit.
Authorized signature
Printed name & title
Date
A valid ACH authorization form must include
Authorization language
Explicit declaration that the payer authorizes the originator to debit their account through the ACH network.
Amount and timing
The payment amount that the originator is allowed to debit and if the authorization is one time or recurring, including the frequency and start date.
Revocation process and deadline
Clearly state the revocation terms and notices that the payer must provide to cancel the ACH authorization.
Bank account type and details
Checking or savings, the financial institution, and the routing and account numbers.
Signature and date
Consumer and business authorizations must be signed physically or authenticated digitally through an eSign process.
Store for two years
Keep the signed form for 2 years after the date on which the authorization terminates or is revoked.
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FAQs
A business asked me to fill out an ACH authorization form. Is this the right form?
Yes, this is the right form. The business that asked you is the one collecting the payment, so put their name as the company receiving the authorization. Then add your own details and bank information, sign and date it, and send it back to them. Keep a copy for your records.
Is this the same as a direct deposit form?
No. This form lets a business pull money out of a bank account. A direct deposit form does the opposite and deposits money into a bank account, like payroll. That kind is an ACH credit authorization, and it is a separate document.
Are ACH authorization forms required?
Yes. Every ACH credit and debit transaction needs explicit authorization. For consumer accounts, it has to be in writing or authenticated electronically. For sending money (credit) to a bank account, the rules do not strictly require a form. But banks and processors usually expect one on file. And if a debit is ever disputed, the signed form is what proves you had permission to pull funds from an account.
Do ACH authorizations have to be signed?
Yes, for consumer debits. The authorization has to be signed or similarly authenticated. An electronic signature counts. But a pen signature on the printed form is the simplest way.
What is a bank-issued ACH authorization form? Do banks like JP Morgan Chase or Bank of America provide one?
No. There is no standard, bank-issued ACH authorization form, and banks like Chase or Bank of America do not provide one for you to send to your customers. The business collecting the payment provides the form. Some banks give their business customers a sample as part of a treasury agreement, but you do not need to wait for one to make your own.
Is there an official NACHA form?
No. NACHA publishes operating rules and sample language, not a standard required form. Any document works as long as it has the required elements. That means clear authorization language, the amount and timing, revocation terms, account details, and a signature.
How long do I need to keep ACH authorization forms?
Keep it for two years after the authorization ends or is revoked. If the payer's bank asks for proof, you need to produce a copy within 10 banking days.
Can a customer revoke an ACH authorization?
Yes. They can revoke it by following the revocation terms outlined in the form. They can also tell their bank to stop payment. Once they revoke the authorization, you must stop debiting their bank account. That is why the form spells out how to revoke and how much notice is needed.
Can I make my own ACH authorization form?
Yes. There is no official format. Any document works as long as it has the six elements in the list above. The fastest and easiest way to generate an ACH authorization form is using Nickel's fillable ACH Authorization Form generator above. You can also start from a blank ACH form template download at the top of this page. Simply enter your business details and payment terms, print it, and have the payer add their bank details and sign.
How do I set up ACH authorization in QuickBooks?
QuickBooks Payments does not let you generate or explicitly request an ACH authorization form. You should generate your own form, ask the customer to sign it, and keep it on file for 2 years after the authorization expires or it is revoked. Nickel syncs with QuickBooks and can help you collect authorization digitally and store the customer's bank details on file for Auto Pay.
What does an ACH authorization form look like?
It's a simple text document with no standard template. It simply needs to follow NACHA's rules, and show the business's name, an authorization clause, the amount and schedule, blank lines for the bank details, checking and savings checkboxes, revocation terms, and a line to sign and date.