Pre Authorization Letter Sample

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Sample Template Example of Standing Indtruction Letter to Bank Manger for  Bank Account Debit in Word / Doc / Pdf Free Download


PRE-AUTHORIZED PAYMENT, SPECIFIC AMOUNT

[DATE, ex. Wednesday, June 11, 2014]

[NAME, COMPANY AND ADDRESS, ex.
John Smith
XYZ Bank
1234 First Street
Suite 567
Anycity, Anystate  85245]

Dear [NAME, ex. John Smith],

You are hereby authorized to withdraw from the following account the amount of [AMOUNT OF PERIODIC DEBIT, ex. $4,299.48] on a [PERIOD OF PAYMENT, ex. monthly, weekly] basis on the [BILLING DATE, ex. 15th day of each month]:

Bank:                            [BANK NAME AND ADDRESS]
Bank Transit No:            [BANK TRANSIT NO., ex. 4444]
Account No:                  [ACCOUNT NUMBER, ex. 12345678]
Bank Tel. No.                [BANK TELEPHONE NO., ex. (XXX) XXX-XXXX]
Bank Contact                [NAME OF BANK CONTACT, ex. Susan Smith, Manager]


This shall be your good and sufficient authority for so doing.

We enclose an unsigned check from the account marked "VOID".

[NOTE: IF MORE THAN ONE SIGNATURE IS REQUIRED ON ACCOUNT, MAKE SURE BOTH BANK SIGNING OFFICERS SIGN LETTER]


Sincerely,



[YOUR NAME, ex. Jill Jones]


Download Pre Authorization Letter Format

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