ContractPre-Authorized Withdrawal Agreement • May 3rd, 2011
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • February 5th, 2022
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • November 14th, 2017
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • March 25th, 2020
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • October 24th, 2013
Property Tax Installment Pre-Authorized Withdrawal AgreementPre-Authorized Withdrawal Agreement • May 7th, 2014
This amount is an estimate based on the current year's taxes. The final payment will be withdrawn from your bank account on the first working day after July 1 each year. Your tax notice will indicate the amount of your new payment for the next tax year.
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • March 20th, 2020
PROTECTIVE LIFE AND ANNUITY INSURANCE COMPANYPre-Authorized Withdrawal Agreement • February 8th, 2022
PRE-AUTHORIZED WITHDRAWAL AGREEMENT FOR DRAFTING OF PREMIUM PAYMENTS The person paying the premium on the life insurance policy listed below must sign this agreement. I request and authorize Protective Life and Annuity Insurance Company to draw against the account listed below to pay premiums once a policy has been issued. I understand that no coverage exists until a policy is issued or I receive a Conditional Receipt. Policy Number: Name of Insured: Name of Bank: Street Address or P.O. Box: City: State: Zip Code: Type of Account: Checking Savings Routing Number: Account Number: Premium Frequency: *Monthly (*Only available by bank draft) Quarterly Semi-Annually Annually Draft the initial premium - I understand that authorizing the drafting of the initial premium and providing the account information does not provide any life insurance coverage on myself or any applicant listed on the application for life insurance unless I have signed, dated and met the term
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • February 19th, 2016
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • July 27th, 2020
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • October 25th, 2013
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • September 2nd, 2024
Pre-Authorized Withdrawal AgreementPre-Authorized Withdrawal Agreement • July 3rd, 2014
PRE-AUTHORIZED WITHDRAWAL AGREEMENTPre-Authorized Withdrawal Agreement • January 29th, 2022
