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ACH Recurring Debit Authorization AGREEMENT FOR DIRECT PAYMENTS
(ACH DEBITS)
Name of
Insured:Policy
Number:I (we) hereby authorize First Benefits Insurance Mutual, Inc. to initiate debit entries to
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How to fill out ach recurring debit authorization
How to fill out ach recurring debit authorization
01
Obtain the ACH recurring debit authorization form from the company or organization that will be debiting your account.
02
Fill out your personal information including your name, address, and contact details.
03
Provide your bank account information including your routing number and account number.
04
Specify the amount to be debited from your account on a recurring basis.
05
Sign and date the form to authorize the company to initiate the debit transactions.
Who needs ach recurring debit authorization?
01
Anyone who wishes to set up recurring payments from their bank account to a company or organization.
02
Companies or organizations that offer services or products on a subscription basis and need to collect payments on a regular schedule.
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What is ACH recurring debit authorization?
ACH recurring debit authorization is a financial agreement that allows a company to automatically withdraw funds from a customer's bank account at regular intervals.
Who is required to file ACH recurring debit authorization?
Businesses or entities that wish to initiate recurring payments from customers are required to file ACH recurring debit authorization.
How to fill out ACH recurring debit authorization?
To fill out ACH recurring debit authorization, one must provide relevant information such as the customer's bank account details, the frequency of the withdrawals, and the authorization agreement signed by the customer.
What is the purpose of ACH recurring debit authorization?
The purpose of ACH recurring debit authorization is to facilitate automatic payments for services or products, ensuring timely and reliable transactions.
What information must be reported on ACH recurring debit authorization?
The information that must be reported includes the customer's name, bank account number, routing number, payment amount, frequency of withdrawal, and customer's signature.
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