Debit Your Account, Repetitive Authorization


Dear Sir or Madam:

You are authorized and directed to debit our Account, named ____________, with our bank account number: ______________, for $ ___________ for a monthly payment to be made on the 15th day of each any every month until you are notified otherwise in writing, the payment being payable to: _________________ (Name), at _____________ (Bank), with account number ________________ and ABA Routing Number _________________. Please charge our account any fees to accomplish this transaction.

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

Best regards,

Authorized Signer of Account
cc Recipient of debit