THE PRE-AUTHORIZED DEBIT AGREEMENT (PDA)Pre-Authorized Debit Agreement • March 4th, 2013
Contract Type FiledMarch 4th, 2013The Payor named below authorizes Humania Assurance Inc. (Humania Assurance) to make scheduled pre-authorized debits (PDA) on the bank account with the financial institution named below, or any other financial institution that the Payor may later designate, for the purpose of paying the insurance premium in accordance with the premium schedule stipulated in the policy contract, including the initial premium.