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Authorization for Automated Debit Entries 1. If you choose bank draft, complete the authorization agreement and attach a voided check, if applicable. Corporation Name: BlueChoice Healthily of South

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What is authorization for automated debit?

Authorization for automated debit is a form that allows a company to automatically withdraw funds from a customer's account for payment.

Who is required to file authorization for automated debit?

Companies or organizations that wish to set up automated debit payments from their customers are required to file authorization for automated debit.

How to fill out authorization for automated debit?

To fill out authorization for automated debit, the company needs to include the customer's name, account information, amount to be withdrawn, frequency of withdrawals, and the customer's signature.

What is the purpose of authorization for automated debit?

The purpose of authorization for automated debit is to allow companies to collect payments from customers in a convenient and efficient manner.

What information must be reported on authorization for automated debit?

Information such as customer's name, account information, amount to be withdrawn, frequency of withdrawals, and customer's signature must be reported on authorization for automated debit.

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