ACH Authorization Form

  • Bank Information

    I (we) hereby authorize Dar El Slam travel Inc to initiate entries to my (our) checking/savings accounts at the financial institution listed below and, if necessary, initiate adjustments for any transactions credited/debited in error. This authority will remain in effect until Dar El Salam Travel is notified by me (us) in writing to cancel it in such time as to afford Dar El Salam travel and THE FINANCIAL INSTITUTION a reasonable opportunity to act on it.
  • Electronic Signature & Date

    Electronic signatures are legally binding as covered by the ESIGN act of 2000 and Uniform Electronic Transactions (UETA) in the USA, the Electronic Signatures Directive of 1999 and 1993 in the EU, and various other laws in most jurisdictions around the world.
  • Personal Information

  • Trip Information

  • What type of trip is this payment for?
  • Is this an initial payment or an installment payment?
  • Account Information