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Preauthorized DebitCustomer nameAddressCertificate numberPostal codeEmailTelephone numbers (Area code + no.) Branch transit numberAccount numberFinancial institute number/we authorize CPA Insurance
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How to fill out pre-authorized debit form

01
To fill out a pre-authorized debit form, follow these steps:
02
Obtain a copy of the pre-authorized debit form from the organization requesting the form.
03
Read the instructions on the form carefully and ensure you understand the terms and conditions.
04
Provide your personal information such as your full name, address, and contact details in the designated fields.
05
Enter your banking information, including your bank account number and transit number.
06
Indicate the frequency of the debits, such as monthly, bi-weekly, or annually, depending on the agreement.
07
Specify the amount to be debited from your account for each transaction.
08
Sign and date the form to authorize the organization to initiate the pre-authorized debits.
09
Retain a copy of the completed form for your records.
10
Submit the form to the organization according to their instructions, which may involve mailing, faxing, or delivering it in person.

Who needs pre-authorized debit form?

01
Pre-authorized debit forms are needed by individuals or businesses who wish to grant permission for an organization to withdraw funds directly from their bank account.
02
Examples of individuals who may need a pre-authorized debit form include:
03
- Customers who want to set up automatic bill payments to ensure timely payments.
04
- Tenants who prefer having their rent automatically deducted from their account.
05
- Donors who wish to make recurring donations to a charitable organization.
06
Businesses that need to make regular payments to suppliers or service providers may also require pre-authorized debit forms.
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A pre-authorized debit form is a document that allows a company or organization to withdraw funds from an individual's bank account on a regular basis, with the individual's consent.
Individuals or businesses who wish to allow automatic deductions from their bank account for payments such as bills, loans, or subscriptions are required to file a pre-authorized debit form.
To fill out a pre-authorized debit form, provide the necessary personal details such as name, address, bank account information, the amount to be debited, frequency of deductions, and sign the form to authorize the transactions.
The purpose of a pre-authorized debit form is to facilitate automatic payments, ensuring timely transactions without the need for manual intervention from the payer.
The pre-authorized debit form must report the account holder's name, address, bank details (account number and branch), the amount to be debited, and the authorization signature.
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