Get the free Insured EFT Authorization Form - PROES, Inc.
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Preferred Due Date:. I (we) authorize Western National Insurance Group and its affiliates (Michigan Millers, Pioneer Specialty, Umiak, Western NationalAssurance, or Western National Mutual) and the
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How to fill out insured eft authorization form
How to fill out Insured EFT Authorization Form:
01
Start by reading the instructions on the form carefully. Understand the purpose of the form and what information needs to be provided.
02
Begin filling out personal information such as your name, address, phone number, and email address. Ensure that all details are accurate and up to date.
03
Provide your insurance policy information, including your policy number, type of coverage, and the effective date.
04
Next, indicate your bank details such as the name of your bank, the branch location, and the account number where you want the electronic funds transfer (EFT) to be deposited. Double-check the account number for accuracy.
05
If you have multiple policies or if you want to allocate different amounts to different policies, specify the breakdown of funds by policy number.
06
Review the authorization section of the form thoroughly. By signing, you are giving permission for the insurance company to electronically withdraw funds from your specified bank account. Ensure that you understand the terms and conditions before signing.
07
Date the form and keep a copy for your records.
08
Submit the filled-out Insured EFT Authorization Form to your insurance company through the designated method (mail, email, or online submission).
Who needs Insured EFT Authorization Form:
01
Policyholders who prefer to make premium payments through automatic electronic fund transfers instead of manual payments.
02
Individuals who have an active insurance policy and wish to simplify the payment process by authorizing automated deductions.
03
Those who want to ensure timely and hassle-free premium payments by eliminating the need for manual check writing or online payments every billing cycle.
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