Web Works Secure Authorization

Order Summary:

Order Date:

06/10/26

Order Amount:

Order Number:

Customer IP:

216.73.216.41

Description:

Checking Account Information:

Please complete all Account Information. All fields are required.

Account Holder Name:

Bank Routing Number:

Bank Account Number:

Billing Information:

Please complete all Billing Information. All fields are required.

Company Name:

First Name:

Last Name:

Address:

Address Line 2:

City:

State:

Zip:

Country:

Phone Number:

Email Address:

Payment Information:

Activation Payment:

Recurring Billing:

Set Up Recurring Billing

Monthly Payment:

Billing Frequency:

By subscribing to a Package and agreeing to the terms above, you are indicating that you have read and accept the terms and conditions found at www.webworkscorp.com/terms.shtml. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree to notify merchant in writing of any changes in my account information or termination of this authorization 15 days prior to the next due date of the charges. I understand that cancellations must be made in writing and I will not dispute merchant debiting my checking/savings account, so long as the amount corresponds to the terms indicated in this contract The authority you give to charge your account will remain in effect until you notify us in writing to terminate the authorization. If the amount of your payment changes, we will notify you at least 10 days before payment date. Your monthly billing cycle begins immediately. Web Works will launch your web site with sample content within 5 days to prevent delays and your content can be updated at any time.