Get Pcip-wa Authorization Agreement For Preauthorized Payments - Wship

This guide provides a detailed walkthrough on how to complete the PCIP-WA Authorization Agreement for Preauthorized Payments - Wship. By following these steps, users can ensure that their payment process is set up accurately and efficiently.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the PCIP-WA Authorization Agreement and open it in the editing interface.
2. In the first section, you will see the 'Member' field. Enter your full name as the member for whom you are setting up the automatic payments.
3. Next, fill in the 'Member Number' field. This is not required if you are a new enrollee. If applicable, provide your member number for identification.
4. In the authorization section, you must select the type of account you will be using for payments. Choose either 'Checking' or 'Savings account' by marking the appropriate box.
5. Fill in the 'Bank Name' field with the name of your bank. This identifies the financial institution that will process the payments.
6. Enter the 'City' where your bank is located, followed by the 'State' and 'ZIP Code' of the bank.
7. You will need to provide the 'Transit/ABA No.' which is a unique number that identifies your bank and the 'Account No.' for the account that will be debited.
8. In the next section, write your full name in the 'Name' field. This is the person authorizing the debit.
9. Record the current date in the 'Date' field to indicate when the form is being completed.
10. Sign the form in the 'Signed' field. Remember that the person signing must be listed on the signature card with the bank for this account.
11. Attach a voided check from the account you are debiting to ensure accuracy in the withdrawal process.
12. Once all fields are completed and the voided check is attached, you can save, download, print, or share the completed form as needed.

Complete your documentation online today to set up your preauthorized payments effortlessly.