Get Payment Authorization Form H1 - Red River Mutual

Filling out the Payment Authorization Form H1 for Red River Mutual can be straightforward if you follow the appropriate steps. This guide provides clear, detailed instructions to help you complete the form effectively and accurately.

Follow the steps to successfully complete the Payment Authorization Form H1 online.

1. Press the 'Get Form' button to obtain the Payment Authorization Form H1 and open it in your preferred editor.
2. In the applicant's full name and postal address section, provide your complete name and current address. Make sure to include relevant postal codes to avoid delays.
3. Enter the brokerage or agency information. Fill in the brokerage name, contact person, their phone number, and email address. Ensure all codes are correctly inputted.
4. In the policy premium data section, input the total estimated policy premium, any applicable provincial sales tax, and installment fee, if desired. Calculate the total estimated cost, ensuring accuracy.
5. Read and acknowledge the consent and disclosure terms carefully. Confirm your understanding by signing in the designated area, which indicates your agreement with the automatic withdrawal process and associated rights.
6. Choose your preferred method of payment by selecting either a single payment option or payment plan. If you select a payment plan, detail the type of plan in the corresponding section.
7. If paying by credit card, enter your card number, expiration date, and your name as shown on the card. Ensure you have authorized the payment if the cardholder's signature differs.
8. If providing bank account information, fill in the financial institution details, account holder information, transit number, institution number, and account number. Ensure that you attach a void cheque.
9. Fill in any additional payment details, including down payment amounts, insurance company additional charges, and the preferred withdrawal date.
10. Finally, review all the information provided for accuracy. Once confirmed, you can save changes, download, print, or share the form as needed.

Complete your Payment Authorization Form H1 online now to ensure a smooth insurance payment process.