AUTHORIZATION TO DEBIT ACCOUNT

. Dear [CONTACT NAME],

This letter is to acknowledge that [COMPANY/INDIVIDUAL] is hereby authorized to debit our account no. [ACCOUNT NUMBER] in the amount of [AMOUNT] for payment of [NATURE OF DEBIT]. Please withdraw the funds from the following bank account:


Bank: [BANK NAME AND ADDRESS]
Bank Transit No: [BANK TRANSIT NO]
Account No: [ACCOUNT NUMBER]
Bank Tel. No. [BANK TELEPHONE NO]
Bank Contact [NAME OF BANK CONTACT & TITLE]


This shall be your good and sufficient authority for doing so. We enclose a blank check from the account marked "VOID".

[NOTE: IF MORE THAN ONE SIGNATURE IS REQUIRED ON ACCOUNT, MAKE SURE BOTH BANK SIGNING OFFICERS SIGN LETTER]

Sincerely,


Your name
Your title
(800) 123-4567
youremail@yourcompany.com

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AUTHORIZATION TO DEBIT ACCOUNT