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Dryden Mutual Insurance Company
P.O. Box 635
Dryden, New York 130530635
6078443748 / 8006948271
6072570312 / 6078448171 (fax)RECURRING EFT/ACH PAYMENT AUTHORIZATION FORM
Direct Payment via EFT/ACH
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How to fill out recurring eftach payment authorization

How to fill out recurring eftach payment authorization
01
To fill out a recurring EFTACH payment authorization, follow these points:
02
Start by obtaining an authorization form from the organization or institution that will receive the recurring payments.
03
Fill in your personal information accurately, including your full name, address, phone number, and email address.
04
Provide your bank account details, including the bank name, branch address, account number, and routing number.
05
Specify the payment frequency, such as monthly, quarterly, or annually.
06
Indicate the start and end date for the recurring payments, if applicable. If there is no end date, leave this field blank.
07
Read and understand the terms and conditions associated with the recurring EFTACH payment authorization.
08
Sign and date the authorization form to confirm your consent to the recurring payments.
09
Keep a copy of the filled-out form for your records.
10
Submit the completed form to the organization or institution as instructed.
11
Monitor your bank account statements regularly to ensure the recurring payments are processed correctly.
Who needs recurring eftach payment authorization?
01
Recurring EFTACH payment authorization is typically required by individuals or businesses who have entered into an agreement to make regular payments to a specific organization or institution.
02
Common examples of people who may need recurring EFTACH payment authorization include:
03
- Subscribers of subscription-based services, such as streaming platforms, magazines, or gym memberships.
04
- Tenants who have set up automatic rent payments to their landlords or property management companies.
05
- Donors who have pledged to make recurring financial contributions to a non-profit organization or charity.
06
- Individuals who have signed up for automatic bill payments with utility companies, credit card issuers, or loan providers.
07
By obtaining recurring EFTACH payment authorization, both the payer and the payee ensure a convenient and automated payment process, eliminating the need for manual transactions each time a payment is due.
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What is recurring eftach payment authorization?
Recurring eftach payment authorization is a consent given by a customer to authorize a company to initiate recurring payments from their bank account.
Who is required to file recurring eftach payment authorization?
Companies or organizations that wish to automatically withdraw funds from a customer's bank account on a recurring basis are required to file recurring eftach payment authorization.
How to fill out recurring eftach payment authorization?
To fill out a recurring eftach payment authorization, the customer must provide their bank account information, authorization for recurring payments, and any other required details as specified by the company.
What is the purpose of recurring eftach payment authorization?
The purpose of recurring eftach payment authorization is to streamline the process of making recurring payments, such as subscription fees or monthly memberships, by automating the payment process.
What information must be reported on recurring eftach payment authorization?
The recurring eftach payment authorization must include the customer's bank account details, the amount and frequency of the payments, the authorization for automatic withdrawals, and any additional terms and conditions.
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