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Electronic Check Authorization Form (U.S. Banks only)PLEASE PRINT OUT AND COMPLETE THIS AUTHORIZATION AND RETURN TO US All information will remain confidential. Name on Account: Case Number: This

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What is electronic check authorization form?

The electronic check authorization form is a document that allows a business to request permission from a customer to electronically debit funds from their bank account for payment.

Who is required to file electronic check authorization form?

Any business that wishes to collect payment via electronic check from customers is required to have customers fill out an electronic check authorization form.

How to fill out electronic check authorization form?

Customers can fill out an electronic check authorization form by providing their bank account information, including account number and routing number, as well as signing and dating the form.

What is the purpose of electronic check authorization form?

The purpose of the electronic check authorization form is to legally obtain permission from a customer to debit funds from their bank account electronically for payment.

What information must be reported on electronic check authorization form?

The electronic check authorization form must include the customer's bank account information, as well as their signature and date to indicate approval for electronic fund transfers.

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