BILLING CHANGE/UPDATE

The TruPowur Billing Update form is designed to ensure that all SaaS License payments are processed accurately, securely, and without interruption. By keeping your credit card and billing information current, Brokers and Agents help maintain continuous access to the TruPowur platform, tools, and services that power their business. This step is essential for remaining in good standing, as all licensing fees are billed electronically using the payment method on file. To ensure proper processing, all billing updates must be submitted at least 30 days prior to the next scheduled billing date, and a DocuSign Credit Card Update Form provided by Accounting must be completed before any changes take effect. Keeping your billing information up to date not only prevents disruptions but also supports a smooth, reliable, and scalable business operation within the TruPowur system.

LICENSE BILLING INFORMATION UPDATE

First Name: *

Last Name: *

Mobile Phone: *

Personal Email: *

Enter the eMail Address that is on your Billing for Verification.

Street Address: *

City: *

State: *

Postal Code/Zip Code: *

AGENT/BROKER CREDENTIALS

What Is Your Agent/Broker Number: *

Enter your TruPowur Three Digit Extension Number (Sales Code) for verification.

What Type of SaaS License Do You Hold: *

Agent SaaS License

Broker SaaS License

What Is Your TruPowur eMail Address: *

BANK ACCOUNT INFORMATION

Cardholder Name on Account: *

Billing/Statement Address on Account: *

Card Number on Account: *

CVV/Security Code: *

Expiration Date: *

Type of Account: *

Debit Card

Credit Card

Bank Account Type: *

Personal Account

Business Account

Upload a Image of the Card showing Name and Card Number: *

PDF, PNG, GIF, JPEG or JPG

AUTHORIZATION AGREEMENT

I authorize TruPowur, Inc. to charge the credit card provided for all applicable SaaS License fees, including recurring monthly charges, and any authorized adjustments related to my account.

This authorization will remain in full effect until I have provided written notice requesting a change or termination, or until TruPowur, Inc. has notified me that this billing method is no longer available.

I understand and agree that all requests to update or change my credit card information must be submitted at least thirty (30) days prior to my next scheduled billing date to allow sufficient time for processing and implementation.

Upon submitting a request for any billing update, I acknowledge that TruPowur Accounting will send a DocuSign Credit Card Update Form, which must be fully completed, signed, and returned before any changes to my billing method can be processed or take effect.

In the event that an incorrect charge is processed, I authorize TruPowur, Inc. to correct the error by issuing an adjustment, including charging or crediting the applicable account as necessary.

I acknowledge that failure to provide timely notice and completed documentation may result in charges being processed using the most recent valid payment method on file. I also understand that maintaining accurate and current billing information is my responsibility to ensure uninterrupted access to the TruPowur platform and services.

Authorized Signature: *

Clear

Name of Authorized Signature Above: *

Effective Date: *