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Com Toll Free 888-DLR-INS4 Lic CA 0D87197 AZ 906944 Fax 805-980-3333 CHECK DRAFT AUTHORIZATION FORM I hereby authorize in the amount of as a draft check. This draft will be debited from my checking account. I certify that I presently have the funds available in this account to cover this check for the amount mentioned above. Motor Dealer Services Insurance Services 4195 Viking Way 210 Long Beach CA 90808 www. motorDEALERservices. I understand and authorize that this draft is to be done on a...
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