Downloadable forms
ACH – Customer Authorization Agreement for Preauthorized Payments
Please print form and fill out completely. ACH cannot be implemented without your signature. Include a voided check. You may fax the completed form and voided check to 817.588.6477 or submit by mail to:
Dyck O’Neal, Inc.
Attn: Payment Processing
PO Box 13370
Arlington, TX 76094
ACH Form (PDF format)
Letter of Authorization to Speak with Third Party
Please print form and fill out completely. Fax the form to the appropriate office.
Arlington fax: 817.588.6477
Addison fax: 972.661.3748
Authorization Letter (PDF format)
Confidential Financial Statement
Please print form and fill out completely. Fax the form to the appropriate office.
Arlington fax: 817.588.6477
Addison fax: 972.661.3748
Confidential Financial Statement (PDF format)
Authorization and Consent to Electronic Communication
Please print form and fill out completely. Fax the form to the appropriate office.
Arlington fax: 817.588.6477
Addison fax: 972.661.3748
Electronic Communication Consent (PDF format)
ACH Change Form
You may fax the completed form to 817.588.6477, email to the address on the form, or submit by mail to Arlington location below:
Dyck O’Neal, Inc.
Attn: Payment Processing
PO Box 13370
Arlington, TX 76094
ACH Change Form (PDF format)
Deficiency Balance or Pay-off Request
Please complete as much information as possible and submit to Pay-Off Request
Pay Off Request (PDF format)
