Get Pre-authorized Payment Plan - Authorization Form

Filling out the Pre-Authorized Payment Plan - Authorization Form online can simplify your premium payments and ensure timely processing. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the form without hassle.

1. Press the ‘Get Form’ button to access the Pre-Authorized Payment Plan - Authorization Form and open it in your preferred editor.
2. In the first section, provide your account number, selecting either checking or savings as your account type. Make sure to enter the exact account number as it appears on your bank documents.
3. Next, include your name in the ‘Name of Customer’ field, ensuring it is printed clearly.
4. Fill in your bank’s transit number, which is crucial for processing transactions.
5. Enter the date you are completing the form in the designated area.
6. Instruct your bank to honor debit entries by entering the name of your bank and its branch location.
7. List the street address, city, state, and ZIP code of your bank to ensure accuracy.
8. Indicate your policy number(s) in the appropriate section for reference by the insurance company.
9. If the insured is someone other than the customer, provide their name and address.
10. Sign the form at the bottom to authorize the process. Ensure your signature matches the one on file with your bank.
11. Attach a 'void' specimen of a check in the designated area using adhesive tape. Confirm that all edges are secured before scanning.
12. After completing all sections of the form, save your changes. You may then download, print, or share the form as needed.

Complete your Pre-Authorized Payment Plan - Authorization Form online today for hassle-free premium payments.