Get the free Automatic Draft Authorization Form

This document serves as a formal authorization for Delta Dental of Virginia to deduct monthly premium payments directly from a designated bank account. It includes fields for bank details, company information, and instructions for submitting the authorization form.

How to fill out automatic draft authorization form

How to fill out automatic draft authorization form

1. Obtain the automatic draft authorization form from your service provider or bank.
2. Fill in your personal information, including your name, address, and contact information.
3. Provide your bank account details, including the account number and routing number.
4. Specify the amount to be automatically drafted and the frequency of the drafts (e.g., weekly, monthly).
5. Indicate the start date for the automatic drafts.
6. Sign and date the form to authorize the automatic debits.
7. Return the completed form to the appropriate service provider or bank.

Who needs automatic draft authorization form?

1. Individuals who want to automate recurring payments for services such as utilities, rent, subscriptions, or loans.
2. Businesses that need to secure regular payments from clients or customers.

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What is automatic draft authorization form?

An automatic draft authorization form is a document that allows an organization or individual to withdraw funds automatically from a bank account on a specified schedule.

Who is required to file automatic draft authorization form?

Individuals or businesses that wish to set up recurring payments automatically from their bank accounts are required to file an automatic draft authorization form.

How to fill out automatic draft authorization form?

To fill out the automatic draft authorization form, you typically need to provide your banking information, the amount to be drafted, the frequency of the payments, and your signature authorizing the withdrawals.

What is the purpose of automatic draft authorization form?

The purpose of the automatic draft authorization form is to grant permission to an organization or individual to access your bank account to withdraw specified amounts at regular intervals without requiring further consent.

What information must be reported on automatic draft authorization form?

The form usually requires your name, address, bank account number, routing number, the amount to be drafted, payment frequency, and your signature.