Free Legal Forms
| Debit Your Account, Repetitive Authorization |
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Date: Dear Sir or Madam: You are authorized and directed to debit our Account, named ____________, with our bank account number: ______________, for $ ___________ for a monthly payment to be made on the 15th day of each any every month until you are notified otherwise in writing, the payment being payable to: _________________ (Name), at _____________ (Bank), with account number ________________ and ABA Routing Number _________________. Please charge our account any fees to accomplish this transaction. This shall be your good and sufficient authority for doing so. Best regards, _____________ Authorized Signer of Account cc Recipient of debit |
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