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AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS OMB No.: 15100059Expires: 11/30/2010(AGENCY NAME)CHECK ONE: STARTCHANGESTOPINDIVIDUAL/ COMPANY INFORMATIONINDIVIDUAL/ORGANIZATION NAME (PLEASE PRINT)STREET
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What is AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTSOMB No Form?

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Authorization agreement for preauthorized allows a person or entity to give permission to another party to automatically withdraw funds from their account on a regular basis.
Any individual or organization that agrees to have preauthorized payments made from their account must file an authorization agreement for preauthorized.
To fill out an authorization agreement for preauthorized, you will need to provide your name, contact information, account details, the amount to be withdrawn, the frequency of withdrawals, and the start date of the agreement.
The purpose of authorization agreement for preauthorized is to establish consent for automatic withdrawals from an account and to specify the terms of the agreement between the parties involved.
The information reported on authorization agreement for preauthorized includes the account holder's name, contact information, account details, the amount to be withdrawn, the frequency of withdrawals, and the start date of the agreement.
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