ACH Authorization Form for
DiversyFund Venture Investment Payment

INVESTOR INFORMATION

BANK ACCOUNT INFORMATION

ACH Payment Information and Manual Processing Authorization

Thank you for choosing to invest with DiversyFund. Please read the following terms and conditions carefully before providing your ACH payment information.

By completing and submitting this form, you authorize DiversyFund to initiate a one-time electronic debit from your designated bank account for the purpose of funding your investment. This authorization is for a single transaction only, as specified in your investment documents, which have been provided to you separately.

Terms and Conditions:

  1. Authorization for ACH Debit: By providing your bank account information and submitting this form, you authorize DiversyFund to electronically debit the amount specified in your investment documents from the designated account at the financial institution indicated below.
  2. Payment Processing: This authorization allows DiversyFund to process a one-time ACH debit for the amount specified. You agree to ensure sufficient funds are available in the designated account to cover the debit.
  3. Bank Account Information: You agree to provide accurate and complete bank account information, including the bank name, account number, and routing number. DiversyFund will use this information solely for the purpose of processing your investment payment.
  4. Transaction Date: The ACH debit will be initiated on the date specified in your investment documents. You will be notified via email once the transaction has been processed.
  5. Insufficient Funds: If the designated account does not have sufficient funds to cover the ACH debit, the transaction may be rejected by your financial institution. In such cases, you may incur additional fees from your bank. DiversyFund is not responsible for any such fees.
  6. Privacy and Security: DiversyFund is committed to protecting your privacy and ensuring the security of your financial information. All provided information will be handled in accordance with our Privacy Policy and will not be shared with unauthorized parties.
  7. Revocation of Authorization: This authorization is for a one-time transaction only. If you wish to revoke this authorization before the transaction date, you must contact DiversyFund in writing at least three business days prior to the scheduled debit date. Please send your revocation request to vcpayments@diversyfund.com
  8. California Residents: If you are a resident of California, you are entitled to certain consumer protections under state law. DiversyFund complies with all applicable California laws and regulations related to electronic funds transfers.
  9. Governing Law: This authorization and any disputes arising out of or relating to it shall be governed by and construed in accordance with the laws of the State of Delaware.
  10. Consent to Store and Process Information: By clicking submit below, you consent to allow DiversyFund, Inc. to store and process the personal information submitted above for the purpose of processing your investment payment and providing you the services requested.
  11. Contact Information: For any questions or concerns regarding this authorization or the ACH payment process, please contact DiversyFund at vcpayments@diversyfund.com
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.