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Get the free AGREEMENT for PRE-AUTHORIZED PREMIUM PAYMENTS - hr columbia

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AGREEMENT for PREAUTHORIZED PREMIUM PAYMENTS (Auto Pay) I (we) authorize Employee Benefit Plan Administration, hereafter called BPA, to withdraw (debit) the amount of my (our) monthly COBRA/Retiree
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How to fill out agreement for pre-authorized premium

01
Begin by reviewing the agreement form for pre-authorized premium.
02
Fill in the necessary personal details such as your name, address, and contact information.
03
Indicate the date on which you wish to start the pre-authorized premium payments.
04
Specify the payment amount and frequency, whether it is a monthly, quarterly, or annual payment.
05
Provide your banking information, including the account number and the name of your financial institution.
06
Sign and date the agreement form.
07
Submit the completed agreement form to the relevant party or organization for processing.

Who needs agreement for pre-authorized premium?

01
Individuals who wish to make regular premium payments for insurance policies, loans, or other services can benefit from having an agreement for pre-authorized premium.
02
Companies and organizations that offer services requiring recurring payments can also use this type of agreement to ensure timely and hassle-free collection of premiums.
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An agreement for pre-authorized premium is a contract between a customer and a financial institution that allows the institution to automatically withdraw funds from the customer's account to pay for premiums on a regular basis.
Both the customer and the financial institution are required to file the agreement for pre-authorized premium.
The agreement for pre-authorized premium can be filled out by providing the necessary information such as the customer's bank account details, the premium amount, and the frequency of withdrawals.
The purpose of the agreement for pre-authorized premium is to simplify the payment process for both the customer and the financial institution, ensuring timely and consistent premium payments.
The agreement for pre-authorized premium must include the customer's bank account information, the amount and frequency of premium payments, and any terms and conditions related to the agreement.
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