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Dale E. Bauwens, MD | Jake D. Bauwens, MD | Jesse E. Bauwens, MD | Steven Donatello, MD | Anthony A. Ferguson, MD | Thomas B. Huizenga, MD | Charles A. Klein, MD David B. Kornreich, DO | Lawrence
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01
Write the date at the top of the form.
02
Fill in your full name as it appears on the account.
03
Enter the name of the payee or organization you are authorizing payment to.
04
Specify the amount you are authorizing to be paid.
05
Sign and date the form to acknowledge your consent for the payment to be processed.

Who needs i authorize payment of?

01
Individuals or businesses who want to authorize a payment to be made on their behalf.
02
Those who want to ensure a specific payment is processed in a timely manner.
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I authorize payment of is a document or form that permits a financial transaction, allowing designated individuals or entities to make payments on your behalf.
Individuals or business entities that need to authorize someone else to make payments on their behalf are required to file this document.
To fill out the form, provide the necessary personal information, specify the amount to be authorized, include details of the payee, and sign the document.
The purpose of this authorization is to legally allow another party to make payments on your behalf, ensuring that transactions are processed correctly and efficiently.
The form must report full names, contact details, the amount authorized for payment, the purpose of payment, and signatures of both the payer and the authorized individual.
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