Bank Account Verification Agreement

To verify a Bank Account, please complete the agreement below:

  1. Enter the account information and print the form.
  2. Sign and date the bottom of the agreement.
  3. Using your smart phone, take a photo of the signed form, along with a photo of a void cheque or your bank statement
  4. (Please ensure that your name and bank account number is clear and legible)
  5. Take a photo of a valid government issued photo ID
  6. Email us the images of the agreement, credit card and your photo ID in JPEG or PDF format to verification@slots.lv.

Government Issued ID

(e.g. Drivers License)

Void cheque OR Bank Statement

 

 

To avoid processing delays, please ensure that the name, address, bank account number and signature on your submitted documents are clearly legible.

Client Information

  •  

IMPORTANT: Please read the following carefully before signing and dating.

By submitting this signed and dated form, along with the additional information requested, I am authorizing and fully acknowledging that:

  • You are requesting an electronic transfer from your own personal bank account.
  • You agree that such requests, by Internet or by telephone, will constitute your authorization for such transfers.
  • You agree that the bank account you register is your own personal chequing or savings account and is not a company bank account or a bank account registered to someone else.
  • It may take up to 7 business days for the deposit to clear your bank account, however funds may be deducted from your bank account in as little as 1-2 days.
  • You agree that any transactions that result in non-sufficient funds (NSF) may be rebilled to your bank account and any fees incurred will be the sole responsibility of the bank account holder.
  • If for any reason your eCash purchase is uncollectible, all activity in your account may be considered invalid.
  • To ensure collection of funds, your account information may be forwarded to your bank, or to a designated collection agency.
  • All delinquent accounts will be reported to the Credit Bureau.
  • Payout requests cannot be processed until funds are received for all deposits made into your account (up to 5 business days after a deposit is made).
  • You agree that you have read and accepted the terms described in the Terms of Service.

Signature

Date

 

Email To

verification@slots.lv

 

Reference No: