Common Contracts

1 similar Authorization Agreement for Electronic Funds Transfer contracts

AUTHORIZATION AGREEMENT
Authorization Agreement for Electronic Funds Transfer • April 2nd, 2018

NAME SERVICE ADDRESS ACCOUNT NUMBER (as shown on utility bill) DESCRIPTION OF DEBITOKALOOSA COUNTY WATER & SEWER UTILITY BILL NAME OF BANK BANK ROUTING TRANSIT/ABA NUMBER (9 digits) BANK ACCOUNT NUMBER (include leading zeros) See check illustration on next page ACCOUNT HOLDER NAME (as shown on bank account)  CHECKING ATTACH A VOIDED CHECK SAVINGS ATTACH A VOIDED DEPOSIT SLIP SIGNATURE SIGNATURE (joint account) DATE PHONE NUMBER DATE PHONE NUMBER

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