By signing, I authorize Mid-West Family - Southwest Michigan (WSJM Inc.) to automatically deduct payment from my credit card to pay for my agreed contract with the company on a monthly basis. The authorization is to remain in effect through the term indicated on the form above. I understand that I am responsible for paying any additional invoices for services rendered outside of this invoice number or product contract not covered by this payment. If I need to make an adjustment to this schedule, I understand that I must contact the business manager within 5 business days of the next recurring payment date, that this current recurring schedule will be cancelled, and a new form will be filled out by my organization to begin a new schedule or payment amount.