If you’re accepting ACH payments by mail, NACHA requires that you send your customer a disclosure statement. In the event of a disputed transaction, you may be asked to share your ACH disclosure.
Here is the format for disclosing your ACH terms from your customer.
Please allow this letter to confirm that you authorized us, <Name of your Business>, to electronically debit your account ending in <XXXX> (show the last 4 digits of the account number) on <date of transaction> in the amount of <$XXX.XX>. This transaction will be a single-entry ACH debit.
Please note that if you wish to revoke this authorization and cancel the debit to your account, you must notify us at <your phone number> and during normal hours of operation before the scheduled debit date.
If you should have any questions concerning this payment transaction, you may contact us at <your phone number> during our normal business hours.
In the unlikely event, your payment is returned unpaid, we may elect to electronically re-present your payment up to two more times.