PRE-AUTHORIZED PAYMENT

. Dear [CONTACT NAME],

This letter is to acknowledge that [COMPANY/INDIVIDUAL] is hereby authorized to withdraw the amount due on our [NATURE OF CHARGES] on a [PERIOD OF PAYMENT] basis on the [NUMBER OF DAYS AFTER BILLING DATE] day after the billing date:


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


This shall be your good and sufficient authority for so doing. We enclose an unsigned 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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PRE-AUTHORIZED PAYMENT