XPS VPN

ACH Payment Authorization

Secure monthly subscription enrollment.

Account Owner Name:

Social Security Number:

Birth Date:

Address:

City:

State:

Zip Code:

Mobile Phone #:

Bank Name:

Routing Number:

Account Number:

Account Type:

Monthly Payment Amount:

First Payment Date:

First payment starts on November 6, 2026

Signature:

Draw your signature with a mouse, stylus, or finger, or auto-generate it from the Account Owner Name.

By signing up for XPS VPN, you agree to enroll in our subscription service at the standard rate of $24.99 per month. Charges will be automatically billed to the payment method provided at the beginning of each subscription period unless cancelled.