Borough of Avalon Tax Collector’s OfficeDirect Debit Authorization Agreement • June 3rd, 2022
PAYOR AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • September 14th, 2020
We authorize BAIS CHAYA MUSHKA SCHOOL, and the financial institution designated (or any other financial institution we may authorize at any time) to begin deductions as per my/our instructions for monthly regular recurring payments and/or one-time payments from time to time, for payment of all charges arising under my/our BAIS CHAYA MUSHKA SCHOOL account(s). Regular monthly payments for the full amount of services delivered will be debited to my/our specified account on the 20th day of each month. BAIS CHAYA MUSHKA SCHOOL will obtain my/our authorization for any other one-time or sporadic debits.
GORE PUBLIC WORKS AUTHORITY 201 S. MAIN ST., PO BOX 329Direct Debit Authorization Agreement • April 20th, 2023
AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • December 20th, 2017
Complete this form to enroll in the Direct Debit Program. Enclose a voided check or a copy of a documentation which indicates the account to be debited.
Direct Debit Authorization AgreementDirect Debit Authorization Agreement • October 10th, 2017
If this date falls on a Saturday, Sunday, or bank holiday, this transfer will automatically be made on the following business day. Not Applicable if “On Demand” Option selected ** Maximum amounts are set for future changes you may require and will only be used upon your instruction. Loan payment transfers MUST be done minimum two (2) days prior to due date (i.e. Due date 15th of month, transfer of funds the 13th of month.)
Direct Debit – Authorization AgreementDirect Debit Authorization Agreement • June 6th, 2024
These payments will automatically withdraw from your bank account on/around the 1st day of each month (to allow for weekends/holidays, etc)
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • July 29th, 2024
Direct Debit Authorization AgreementDirect Debit Authorization Agreement • March 8th, 2018
(“Employer”), agree as follows with regard to payment of the obligations incurred by BCBST on behalf of Employer, pursuant to the Agreement by and between BCBST and Employer.
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • June 9th, 2020
Direct Debit Authorization Agreement For Sun Life Financial Credit CardDirect Debit Authorization Agreement • December 12th, 2019
Name of Company公司名稱 New Business新保單 Change of Payment Mode更改付款形式 Change of Account Number更改自動轉賬號碼 Please “✓” the appropriate option請“✓”適當之選項 Please read the 4. Important Notes before you sign this Authorization. Please complete both pages of this Authorization.請在簽署本授權書前細閱「4. 重要事項」。請填寫及簽署本授權書之第一及第二頁。 Please complete and return this form to Sun Life Hong Kong Limited.請填寫並將此授權書交予香港永明金融有限公司。 I/We, the Cardholder/Applicant of the following credit card account, hereby authorize Sun Life Hong Kong Limited ("the Company") to effect the debits from my/our credit card account, in accordance with such instructions as my/our account may receive from the Company from time to time. This authorization is valid even after the renewal of my/our credit card until written statement to the contrary.本人／我們，乃下列信用卡之持有人／申請人，現授權香港永明金融有限公司（ “公司”）經由下列信用卡戶口，根據該公司不時給予本人／我們信用卡之指示自本人之賬戶內轉賬予上述公司。此授權書於下列信用卡續領後，仍然生效，直至本人／我們以書面另行通知為止。The HK Dollar equivalent will be based on the US Dollar exchange rate as determine
Optional Direct Debit Authorization AgreementDirect Debit Authorization Agreement • August 13th, 2018
AUTHORIZATION AGREEMENT FOR PRE-ARRANGED PAYMENTSDirect Debit Authorization Agreement • July 7th, 2015
This authority is to remain in full effect until the Tricia Sloan Dance Center has received written notification from me of its termination in such time and in such manner as to afford COMPANY or BANK a reasonable opportunity to act on it.
CLIENT DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • July 29th, 2015
This authorization is to remain in full force and effect until ContinuumHR has received written notification by CLIENT of its termination in such manner as to afford ContinuumHR and DEPOSITORY a reasonable opportunity to act on it.
Authorization Agreement for Preauthorized PaymentsDirect Debit Authorization Agreement • November 29th, 2017
For your convenience, you have the option to pay your premium with automatic direct debit. If you are interested in setting up this transaction, please complete the following form to authorize the WEA Trust to directly deduct your premium from your financial institution.
City of George - Direct Debit Authorization AgreementDirect Debit Authorization Agreement • October 2nd, 2019
NAME: PHONE: ADDRESS FOR SERVICE: PO BOX: CITY: GEORGE STATE: IA ZIP: 51237 I authorize the City of George and Security Savings Bank of George, Iowa to initiate debit entries to pay my City of George utility bill. The amount of debit will be determined by the monthly utility amount mailed to customer around the 15th of each month. I understand the debit will be processed on the same day new bills are made but will not be deducted from my banking account until the 25th of each month. This authorization is to remain in full force and effect until (1) The City of George has received written notice to cancel the direct debit (2) The City of George terminates agreement for consistent misuse by patron. Please provide a blank voided check or copy of a check for verification. A charge of $30.00 will be assessed for NSF account.
MLGW AutoPay DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • August 8th, 2019
This authorization is to remain in full force and effect until Memphis Light Gas & Water has received written notification from me of its termination in such time and in such manner as to afford Memphis Light Gas & Water a reasonable opportunity to act on it.
MLGW AutoPay DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • August 13th, 2014
This authorization is to remain in full force and effect until Memphis Light Gas & Water has received written notification from me of its termination in such time and in such manner as to afford Memphis Light Gas & Water a reasonable opportunity to act on it.
ContractDirect Debit Authorization Agreement • January 28th, 2022
County Auditor’s Form 802 DIRECT DEBIT AUTHORIZATION AGREEMENTHarris County, Texas (REV. 07/10)This authorization form gives Harris County or Harris County Flood Control District and your financial institution the authority to directly debit your account.I authorize Harris County and the financial institution listed below to debit my account automatically for my insurance premium on each scheduled due date. If Harris County erroneously debits my account, I authorize Harris County to correct the error by initiating an adjusting debit/credit entry or to adjust the entry on my next scheduled due date. I acknowledge and agree that this authorization may be rejected or discontinued by Harris County at any time. I understand that this authorization replaces any previous Direct Debit authorization, and unless terminated by Harris County, this authorization will remain in full force and effect until Harris County has received written notification from me of its termination in such time as to a
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • October 29th, 2020
The undersigned hereby authorizes the Village of Smithton, Illinois to directly withdraw from the following account, payment for all utility services provided by the Village of Smithton to the undersigned:
St. Paul’s United Methodist ChurchDirect Debit Authorization Agreement • November 20th, 2020
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • September 14th, 2022
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • June 10th, 2016
This authority shall remain in effect until terminated upon fifteen (15) days written notice by either Customer or Jebro. Notice of termination shall in no way affect debit entries initiated prior to actual receipt of notice.
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • May 31st, 2021
NRCC DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • June 6th, 2022
ContractDirect Debit Authorization Agreement • August 16th, 2023
Lower Township Municipal Utilities Authority Direct Debit Authorization Application and Agreement I authorize the Lower Township MUA to debit the below specified bank account for my sewer and/or water bills. I understand that there will be a $20.00 charge for any debits that are returned unpaid. I will keep my information up-to-date with the LTMUA. Account Must be Current When Application is Processed LTMUA Account Number: Name on Account: Property Address: Mailing Address Telephone Number: Cell Number: Email Address:
Bedford Township DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • October 19th, 2004
Borough of Avalon Tax Collector’s OfficeDirect Debit Authorization Agreement • February 1st, 2023
Direct Debit Authorization Application and AgreementDirect Debit Authorization Agreement • October 7th, 2015
Virginia Run Community Association Authorization Agreement for Direct PaymentDirect Debit Authorization Agreement • July 20th, 2021
Please send the completed form to management@virginiarun.com or drop it off in the door mail slot at the Community Center, 15355 Wetherburn Court, Centerville, VA 20120.
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • September 24th, 2013
This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it, but in no event less than ten (10) working days from receipt of the written notification.
Optional Direct Debit Authorization AgreementDirect Debit Authorization Agreement • August 1st, 2019
Authorized Agreement for Direct Debit PaymentDirect Debit Authorization Agreement • January 30th, 2023
BORROWER DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • April 27th, 2016
ContractDirect Debit Authorization Agreement • August 28th, 2017
Check applicable box. In all cases, you must sign this form in order for it to be valid. If more than one person is on the account to be debited, all named parties on the account must sign this agreement.
DIRECT DEBIT AUTHORIZATION AGREEMENTDirect Debit Authorization Agreement • March 3rd, 2021
The undersigned hereby authorizes the Village of Smithton, Illinois to directly withdraw from the following account, payment for all utility services provided by the Village of Smithton to the undersigned:
