I authorize Your Renters Insurance, LLC (d/b/a ___________) and/or ____________, on behalf of its licensed insurance company subsidiaries (hereinafter “Your Renters Insurance”), to periodically charge my credit card or debit my selected bank account, pursuant to the payment schedule for my Your Renters insurance policy or policies plus a service fee applied to each installment payment of each installment payment of $5.00 for semi-annual and quarterly check payments, $3.50 for monthly check payments and $2.50 for recurring EFT or recurring credit card transactions.

I authorize my financial institution to accept the payment demand from Your Renters Insurance. I agree to maintain, at all times, sufficient funds or credit in the selected account.

I understand that if a payment is denied by my financial institution, Your Renters Insurance will consider my premium unpaid and the policy or policies may be cancelled for non-payment in accordance with each policy and applicable law.

I understand that if Your Renters Insurance isn’t paid because of non-sufficient funds or credit, Your Renters Insurance may make multiple attempts to obtain payment, possibly resulting in additional fees or charges from my financial institution.

I also understand that any unpaid bills may result in fees described in my policy and I authorize Your Renters Insurance to collect those fees by electronic charges to my credit card or debits to my bank account, including a charge or debit to collect a non-sufficient funds (“NSF”) fee of up to $40.00 subject to state law. The amount of the NSF fee is located in the Important Notice Billing Reference Information included in my policy packet. This payment authorization is valid for the life of any Your Renters Insurance policy or policies. I agree and understand that Your Renters Insurance may, at any time, terminate this arrangement and require another payment method.

I acknowledge that Your Renter Insurance will 1) notify me in writing of the amount of debit or charge before the first EFT transaction; 2) notify me if the amount changes; 3) charge or debit my account on or after the date of the month I select, or, if I make no selection, on the same day of each month as the date of the policy’s inception.

I acknowledge that I may recover the amount of any erroneous charge or debit, either by check or credit to my account by calling and notifying Your Renters Insurance at _________ promptly if an error has occurred.

I acknowledge that I have the right to terminate this authorization at any time by providing 15 days written notice mailed to Your Renters Insurance, ________________, or faxed to ___________.

I will retain a copy of this authorization.

You must enroll in Paperless Statements and agree to access your policy documents and statements you are provided in connection with your agreement with Your Renters Insurance Group electronically. You understand that Your Renters Insurance Group will NOT mail printed documents to your address of record. By accepting the Agreement, you give your consent to receive electronic notice of any notice or other type of communication provided to you by Your Renters Insurance Group. Your consent also covers all disclosures that are required or may be provided on or with your account. You are required to have and email address in order to access your documents and you will be automatically enrolled if you have not already done so.