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FS Form 54413 E
U.S. Department of the Treasury
Bureau of the Fiscal ServiceAUTOCHARGE AGREEMENT
TO DELIVER AND CHARGE FOR SECURITIES AWARDED
IN DEPARTMENT OF THE TREASURY AUCTIONS
This agreement
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How to fill out autocharge agreement

How to fill out autocharge agreement
01
To fill out the autocharge agreement, follow these steps:
02
Obtain a copy of the autocharge agreement form from the service provider.
03
Read and understand the terms and conditions of the agreement.
04
Fill in your personal information accurately, including your full name, address, contact details, and identification number.
05
Provide your bank account details, including the account number and the name of the bank.
06
Specify the amount you authorize the service provider to charge from your bank account and the frequency of the charges (e.g., monthly, quarterly, annually).
07
Sign the agreement, indicating your consent and agreement to the terms and conditions.
08
Return the filled-out and signed agreement form to the service provider through the designated channels, such as in-person submission, mail, or online submission.
09
Keep a copy of the signed agreement for your records.
Who needs autocharge agreement?
01
Autocharge agreement is useful for individuals or businesses who wish to automate regular payments for services or products.
02
Specifically, it is needed by:
03
- Customers who want to set up automatic bill payments to ensure timely payments and avoid missing due dates.
04
- Subscribers to subscription-based services that require recurring payments, such as streaming platforms, online memberships, or utility bills.
05
- Business owners who want to facilitate regular payments from their customers, such as monthly subscription fees or installment plans.
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- Organizations that want to collect regular donations or membership fees.
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- Any individual or entity that prefers the convenience and ease of automated payments over manual payments.
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What is autocharge agreement?
Autocharge agreement is a written agreement between a customer and a company authorizing the company to automatically charge the customer's account for goods or services.
Who is required to file autocharge agreement?
Any customer who wishes to authorize a company to automatically charge their account is required to file an autocharge agreement.
How to fill out autocharge agreement?
To fill out an autocharge agreement, the customer must provide their personal information, payment details, and authorize the company to charge their account for goods or services.
What is the purpose of autocharge agreement?
The purpose of an autocharge agreement is to simplify the payment process for both the customer and the company, ensuring timely payments and convenience.
What information must be reported on autocharge agreement?
The autocharge agreement must include the customer's name, contact information, payment details, authorization for automatic charges, and any other relevant terms and conditions.
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