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Get Dell Preferred Account

AUTOPAY AUTHORIZATION FORM Yes I want to enroll in the Dell Preferred Account AutoPay Plan. Please read the Dell Preferred Account Authorization Agreement below carefully. /Mrs. /Ms. circle Dell Preferred Account Number 68794501 Email Address - Phone SECTION 2 BANKING INFORMATION Name on Account Mr. A voided check MUST accompany this form. Your name must appear on both the bank account as an authorization signer and on your Dell Preferred Account. I understand that it is my responsibility to notify Dell This is a please check one New Auto Pay Request Change to existing information SECTION 1 DELL PREFERRED ACCOUNT INFORMATION Customer Name Mr. If you have questions contact Customer Service at 800-283-2210 or USDFSCustomerExperience dell.com. I authorize Dell Financial Services to initiate electronic debit entries from my bank account for my Dell Preferred Account monthly payments as indicated below from the date of this agreement. If you would like to take advantage of this convenient way to make your payments return this completed form and a voided check to Dell Financial Services. I understand that any past due amount or fees will be deducted from my account in addition to the payment amount specified below. I understand that if I decide to terminate this agreement I must notify Dell Financial Services in writing at least 21 days before the next schedule debit. /Mrs. /Ms. circle Account Type check one Bank Name Bank Routing Number Checking Savings See example below for location of numbers on voided check. Bank Account Number SECTION 3 PAYMENT AMOUNT Check the monthly payment amount you would like debited from your bank account each month. Minimum Payment Due Specific Amount. We will automatically deduct the Minimum Payment Due if it is more than the amount specified* To pay any additional amount please send the payment as indicated on your monthly statement or contact DFS customer service. SECTION 4 SIGNATURE Printed Name Signature Date BY MAIL BY FAX P. O. BOX 81577 Austin TX 78708-1577 Customer Service 512 283-1854 Mail form and voided check to PLEASE INCLUDE A VOIDED BANK CHECK A photocopy is acceptable You should retain a copy of this form for your records. Fax form and copy of voided check to Look at the bottom left of your check for the Bank Routing Number and Bank Account Number. I understand that any past due amount or fees will be deducted from my account in addition to the payment amount specified below. I understand that if I decide to terminate this agreement I must notify Dell Financial Services in writing at least 21 days before the next schedule debit. /Mrs. /Ms. circle Account Type check one Bank Name Bank Routing Number Checking Savings See example below for location of numbers on voided check. Bank Account Number SECTION 3 PAYMENT AMOUNT Check the monthly payment amount you would like debited from your bank account each month. Bank Account Number SECTION 3 PAYMENT AMOUNT Check the monthly payment amount you would like debited from your bank account each month. Minimum Payment Due Specific Amount. We will automatically deduct the Minimum Payment Due if it is more than the amount specified* To pay any additional amount please send the payment as indicated on your monthly statement or contact DFS customer service.

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