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PreAuthorized Payment (Debit)
Service Authorization AgreementDONOR INFORMATION
Name (Please Print)
Home AddressCityBest Daytime Phonemic AddressStateZip Code DEBIT AGREEMENT
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How to fill out pre-authorized debit agreement pad
How to fill out pre-authorized debit agreement pad
01
To fill out a pre-authorized debit agreement pad, follow these steps:
02
Write your name and contact information (address, phone number, and email) at the top of the pad.
03
Provide your bank account details, including the account holder's name, account number, and branch transit number.
04
Specify the frequency of the debits (e.g., monthly, bi-monthly) and the date when the debits should be processed.
05
Indicate the amount to be debited and the purpose of the debits.
06
Sign and date the agreement pad to express your consent to the pre-authorized debits.
07
Keep a copy of the filled-out pad for your records.
08
Submit the agreement pad to the appropriate party or organization as instructed.
Who needs pre-authorized debit agreement pad?
01
Anyone who wants to authorize regular debits from their bank account can use a pre-authorized debit agreement pad.
02
This can be useful for individuals or businesses that need to pay recurring bills or make regular payments, such as utility bills, loans, subscriptions, or membership fees.
03
Using a pre-authorized debit agreement pad ensures a convenient and automated payment method while reducing the chances of missed payments or late fees.
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What is pre-authorized debit agreement pad?
Pre-authorized debit agreement pad is a form that allows a payee to automatically withdraw funds from a payer's account.
Who is required to file pre-authorized debit agreement pad?
The payee is required to file the pre-authorized debit agreement pad.
How to fill out pre-authorized debit agreement pad?
The pre-authorized debit agreement pad can be filled out by providing information such as the payer's name, account number, amount to be withdrawn, frequency of withdrawals, and authorization signature.
What is the purpose of pre-authorized debit agreement pad?
The purpose of pre-authorized debit agreement pad is to authorize a payee to withdraw funds from a payer's account on a regular basis.
What information must be reported on pre-authorized debit agreement pad?
The pre-authorized debit agreement pad must include the payer's name, account number, amount to be withdrawn, frequency of withdrawals, and authorization signature.
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