Autopay

By enrolling in automatic payments (auto pay), I authorize California Dental Association (“CDA”) to deduct my Dues (as defined below) either by electronic fund transfers (“EFT”) or by credit card (“Credit Card”). In the case of EFT, I authorize CDA to initiate automated debits to the checking account shown on the next screen, and authorize the depository institution shown on the next screen (“Bank”) to debit such account for such amounts. This authorization includes all adjusting entries, either debit or credit, that may be required. In the case of Credit Card, I authorize CDA to charge the credit card shown above on a monthly basis for payment of my Dues (as defined below). The first EFT debit or Credit Card charge will be on the day of my enrollment in automatic payments. However, the first EFT debit may be delayed up to approximately four (4) additional business days. Subsequent EFT debits or Credit Card charges shall be made on the 15th day of each succeeding month of the membership year. In the case of EFT, if the scheduled date of a debit falls on a weekend or a legal or business holiday, the debit will occur on the next business day. Each EFT debit or Credit Card charge shall be in an amount approximately equal to a fraction (the numerator of which shall be “1” and the denominator of which shall be the number of months in the membership year in which automated debits will be made) multiplied by the sum of (a) the total tripartite and voluntary dues for the membership year to the CDA, American Dental Association, and other recipients designated by me (“Dues”) on a reminder notice that will be sent to me, plus (b) a $12 annual service charge to enroll in the automatic payments program. I agree to pay all such amounts. If there are insufficient funds to cover an EFT debit, the Bank account or Credit Card is frozen or closed, I stop payment on the EFT debit, or the EFT debit or Credit Card charge is not made for any other reason, I remain responsible for paying the Dues installment directly to CDA on a timely basis. If an EFT debit or Credit Card charge cannot be made, CDA is authorized to attempt to initiate the EFT debit or Credit Card charge again at a later time. If, for any reason, an EFT debit or Credit Card charge is dishonored, I agree to pay CDA a fee of $25. CDA is not liable for any losses incurred by reason of any failure in the automated EFT debit or Credit Card charge process. I am responsible for any fees that may be imposed by my Bank or Credit Card company. If my Bank account or Credit Card is frozen or closed, there are insufficient funds in my Bank account, or the EFT debit or Credit Card charge is not made for any other reason on any two EFT debit or Credit Card charge dates, CDA may terminate the automatic payments by giving me written notice at my address as shown in CDA’s records. My membership will be automatically renewed each year unless I tell you to stop. Before the start of each renewal, I will be sent a reminder notice stating the Dues then in effect, including the amount paid in the previous membership year for voluntary dues to the CDA, American Dental Association, and other recipients designated by me. I may change the amount of my voluntary dues by notifying the CDA Contact Center at 800.232.7645. If I do nothing, my Bank account or Credit Card will be charged for the total amount of the Dues stated on the notice and in the manner set forth above, except that the EFT debit or Credit Card charge for the first month of the membership year shall be on 15^th day of the month. I may terminate automatic payments by notifying CDA at 1201 K Street, 14th Floor, Sacramento, CA 95814, Attention Membership, and the termination will be effective seven (7) business days after the date the notice is received by CDA. Following any termination of automatic payments by either CDA or me, I will be responsible for paying my remaining Dues in full, directly to CDA. Note that the CDA membership year begins on your initial join date for a twelve (12)-month period. If I have two consecutive months of failed payments, I will be subject to membership cancellation, with no option of refunds or applying the dues rendered to future memberships. Once membership has been cancelled, there is not an option for membership reinstatement. To rejoin CDA and continue membership, I will need to complete a new membership application and reenroll in automatic payments or pay membership in full. This authorization shall be governed by and interpreted in accordance with the laws of the State of California, without giving effect to any choice of law rule that would cause the application of the laws of any other jurisdiction to the rights and duties of the parties.

Please keep a copy of this authorization for your records.

By enrolling in automatic payments (auto pay), I authorize California Dental Association Foundation (“CDA Foundation”) to make my charitable donation either by electronic fund transfers (“EFT”) or by credit card (“Credit Card”). In the case of EFT, I authorize CDA Foundation to initiate automated debits to the checking account shown on the next screen, and authorize the depository institution shown on the next screen (“Bank”) to debit such account for such amounts. This authorization includes all adjusting entries, either debit or credit, that may be required. In the case of Credit Card, I authorize CDA Foundation to charge the credit card shown on the next screen on a monthly basis for payment of my charitable donation. The first EFT debit or Credit Card charge will be on the day of my enrollment in automatic payments (“Enrollment Date”). However, the first EFT debit may be delayed up to approximately four (4) additional business days. For evergreen donations, subsequent EFT debits or Credit Card charges shall be made on the same calendar day as my Enrollment Date of each succeeding month unless I tell you to stop; for one-time donations, subsequent EFT debits or Credit Card charges shall be made on the same calendar day as my Enrollment Date of each succeeding month for a total of twelve months. In the case of EFT, if the scheduled date of a debit falls on a weekend or a legal or business holiday, the debit will occur on the next business day. For evergreen donations, each EFT debit or Credit Card charge shall be in the monthly donation amount shown on the next screen; for one-time donations, each EFT debit or Credit Card charge shall be in an amount equal to a fraction (the numerator of which shall be “1” and the denominator of which shall be “12”) multiplied by the one-time donation amount shown on the next screen. If an EFT debit or Credit Card charge cannot be made, CDA Foundation is authorized to attempt to initiate the EFT debit or Credit Card charge again at a later time. If, for any reason, an EFT debit or Credit Card charge is dishonored, I agree to pay CDA Foundation a fee of $25. CDA Foundation is not liable for any losses incurred by reason of any failure in the automated EFT debit or Credit Card charge process. I am responsible for any fees that may be imposed by my Bank or Credit Card company. If my Bank account or Credit Card is frozen or closed, there are insufficient funds in my Bank account, or the EFT debit or Credit Card charge is not made for any other reason on any two EFT debit or Credit Card charge dates, CDA Foundation may terminate the automatic payments by giving me written notice at my address as shown in CDA Foundation’s records. I may terminate automated debits by notifying CDA Foundation at 1201 K Street, Suite 1511, Sacramento, CA 95814, Attention Operations Manager, and the termination will be effective ten (10) business days after the date the notice is received by CDA Foundation. This authorization shall be governed by and interpreted in accordance with the laws of the State of California, without giving effect to any choice of law rule that would cause the application of the laws of any other jurisdiction to the rights and duties of the parties.