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Secure Payment Form

By entering your information below, you authorize HCM Unlocked to:

(a) to initiate recurring automated clearing house (ACH) debit entries from the checking or savings account you specify, or (b) to initiate recurring charges from your specified credit card.

 

The amount debited from your checking or savings account or charged to your credit card every month will be the current balance on your account for the previous month’s work. Your current balance is the amount agreed upon on the Statement of Work, plus additional charges billed to your account if applicable. Once your enrollment is processed, all payments will be automatically withdrawn from your specified checking or savings account or charged to the designated credit or debit card on the statement due date, unless you terminate your authorization.

Acknowledge

Please select one of the following:

Account Info
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or

Credit Card Info

Thank you.