Authorization Form to Receive Online Payments
Email address *
I hereby authorize Development, LLC dba Develop Model Management to deposit my payments to the bank account listed below. I acknowledge that transactions initiated to the bank accounts must comply with the provisions of U.S. law. This authorization will remain in effect until I notify Develop Model Management to cancel. *
Required
Model/Talent Name (First and Last Name) *
Date
MM
/
DD
/
YYYY
Name on Bank Account *
Street Address *
City, State, Zip Code *
Telephone Number *
Bank Name *
City/State of Bank *
Example of information needed. Check number not required.
Type of Account (check one) *
Required
Bank Routing Number *
Account Number *
Re-enter Account Number *
Signature (Type Full Name) *
Date of Signature
MM
/
DD
/
YYYY
Submit
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