ACH Form

This form is for setting up auto draft for your monthly service.

Recurring Payment Authorization Form

Schedule your payment to be automatically deducted from your bank account. You simply need to complete this form and upload a picture of a voided check. There is a place at the bottom of the form where you will be able to upload your voided check.

Recurring Payments Will Make Your Life Easier

It’s convenient (saving you time and postage) Your payment is always on time (even if you’re out of town)

You authorize regularly scheduled charges to your checking/savings account. You will be charged the amount indicated below that you were quoted each billing period. The charge will appear on your bank statement as an “ACH Patriot Oxford”. You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected. PLEASE ALLOW UP TO 45 DAYS TO PROCESS APPLICATION.


I authorize Patriot Pool & Spa to charge my account indicated below for the agreed upon price as listed below, on the 15th of each month for payment of my cleaning bill. I also authorize Patriot Pool & Spa to add any repairs that I have approved to my ACH payment when necessary.