Get Authorization For Eriexpresspay Direct Debit Program

Filling out the Authorization For ERIExpressPay Direct Debit Program online is a straightforward process that allows you to set up automatic payments for your insurance premiums. This guide will provide you with clear instructions on how to complete each section of the form efficiently.

Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to acquire the form and access it in your online editor.
2. Begin by entering your personal and policy information. In the 'Policy Information' section, provide your name, business name if applicable, and your daytime phone number. Additionally, list the policy number, your agent's agent number, and the line of business. Specify the policy effective date.
3. For bank account information, enter the name as it appears on your bank account, along with the ABA transit number and bank name. Input your account number and check whether it is a checking or savings account.
4. If you wish to choose an alternate debit date, indicate that date in the appropriate field. This option allows the payment to be withdrawn between 1 to 30 days from your monthly effective date.
5. Thoroughly review the 'Terms and Conditions' provided on the second page of the form. Ensure you understand your rights and responsibilities under this authorization.
6. On the second page, the account holder is required to sign and date the form to validate the authorization for debits from the account.
7. After completion, save any changes made to the document. You can then download, print, or share the form as needed.

Start filling out the Authorization For ERIExpressPay Direct Debit Program online today to simplify your insurance premium payments.