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ASSURANCE AMERICA MANAGING GENERAL AGENCY
AUTHORIZATION FOR AUTOMATIC PAYMENT PLAN
Assurance America Insurance Company is hereby authorized to initiate electronic entries against the
checking account
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How to fill out recurring eft-cc authorization formdocx
01
To fill out the recurring EFT-CC authorization form, follow these steps:
02
Open the formdocx document on your computer.
03
Begin by entering your personal information, such as your name, address, and contact details, in the designated fields.
04
Next, provide your banking information, including your bank's name, account number, and routing number.
05
Specify the frequency and amount of the recurring electronic funds transfer or credit card charge. This may include details like the desired start date, recurring intervals (weekly, monthly, etc.), and the precise amount to be transferred or charged.
06
Make sure to read and understand the terms and conditions of the authorization. If you agree, sign and date the form at the bottom.
07
Once you have completed all the necessary fields, save the formdocx document to your computer or print it out for submission.
08
Submit the form to the appropriate recipient, whether it's your bank, an organization, or any other entity requiring the authorization.
Who needs recurring eft-cc authorization formdocx?
01
Anyone who wishes to authorize recurring electronic funds transfers or credit card charges needs the recurring EFT-CC authorization formdocx.
02
This form is commonly required by individuals or businesses who want to set up automatic payments or transfers from their bank accounts or credit cards.
03
It may be used by utility companies, financial institutions, subscription-based services, or any other organization that relies on regular payments from its customers.
04
Once filled and submitted, this form grants permission to deduct funds from a designated bank account or charge a credit card periodically as per the agreed terms.
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What is recurring eft-cc authorization formdocx?
Recurring eft-cc authorization formdocx is a document used to authorize automated recurring payments from a customer's bank account or credit card.
Who is required to file recurring eft-cc authorization formdocx?
Any individual or organization that wishes to set up recurring payments from a customer's bank account or credit card is required to file the form.
How to fill out recurring eft-cc authorization formdocx?
To fill out the form, the person or organization must provide their contact information, bank account/credit card details, payment amount and frequency, and sign the authorization.
What is the purpose of recurring eft-cc authorization formdocx?
The purpose of the form is to establish a legally binding agreement between the customer and the person/organization receiving the recurring payments.
What information must be reported on recurring eft-cc authorization formdocx?
The form must include the customer's name, contact information, bank account/credit card details, the amount and frequency of the payments, and a signature authorizing the payments.
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