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Upholding a tradition of excellence since 1992 ACH Debit Payment Authorization Form BILLING INFORMATION: Business Name: Business Address: City State ZIP Email: Work Phone: () Contact Person: OPTION
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Ach debit payment authorization is a written agreement between a payer and payee that authorizes the payee to debit funds from the payer's bank account through the Automated Clearing House (ACH) network.
Any individual or business that wishes to receive payment through ACH debits is required to have the payer file an ACH debit payment authorization.
To fill out an ACH debit payment authorization, the payer must provide their name, bank account information, the payee's information, and specify the amount and frequency of the debits. The authorization may also require a signature or electronic consent.
The purpose of an ACH debit payment authorization is to establish a legal and binding agreement between the payer and payee that allows the payee to initiate electronic debits from the payer's bank account.
The ACH debit payment authorization must include the payer's name, bank account information, payee's information, the specific amount and frequency of debits, and any necessary signatures or electronic consent.
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