Direct Withdrawal Agreement Form for Tuition PaymentsDirect Withdrawal Agreement • February 10th, 2019
Authorization Agreement I hereby authorize Skokie School District 73½ to initiate automatic withdrawals from my account at the financial institution named below. I also authorize Skokie School District 73½ to make deposits from this account in the event that a debit entry is made in error.Further, I agree not to hold Skokie School District 73½ responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in withdrawing funds from my account.This agreement will remain in effect until all tuition payments for the 2019-2020 Preschool Program school year have been processed.Two-week written notice is required to withdraw a student. Payment for the two-week notification period is required. Account Information Name of Bank/Financial Institution: Routing Number: Checking Savings Account Number: Signature Authorized Signature (Primary): Date: Auth
Direct Withdrawal Agreement FormDirect Withdrawal Agreement • September 9th, 2020
Direct Withdrawal Agreement Form for Tuition PaymentsDirect Withdrawal Agreement • February 10th, 2019
Direct Withdrawal Agreement Form for Tuition PaymentsDirect Withdrawal Agreement • February 1st, 2017
Direct Withdrawal Agreement FormDirect Withdrawal Agreement • December 6th, 2012
I/We hereby authorize Greater Victoria Visitors & Convention Bureau (Tourism Victoria) to initiate automatic withdrawals to my account from the financial institution named below.
Direct Withdrawal Agreement FormDirect Withdrawal Agreement • May 29th, 2009
This agreement will remain in effect until Hampden Township receives a written notice of cancellation from me/us or my/our financial institution or until I/We submit a new direct withdrawal form to the Utility Department.
DIRECT WITHDRAWAL AGREEMENT FORMDirect Withdrawal Agreement • February 5th, 2016
Direct Withdrawal FormDirect Withdrawal Agreement • October 7th, 2021
Attached please find a voided check. The information is for the Academy of Danse to use to deduct tuition automatically from my checking account.
Direct Withdrawal Agreement FormDirect Withdrawal Agreement • December 24th, 2020
This agreement will remain in effect until Hampden Township receives a written notice of cancellation from me/us or my/our financial institution or until I/We submit a new direct withdrawal form to the Utility Department.
