Pre-Authorized Payment_Specific Amount Template

This pre-authorized payment_specific amount template has 1 pages and is a MS Word file type listed under our finance & accounting documents.

Sample of our pre-authorized payment_specific amount template:

OBJECT: PRE-AUTHORIZED PAYMENT, SPECIFIC AMOUNT Dear [CONTACT NAME], This letter is to acknowledge that [COMPANY/INDIVIDUAL] is hereby authorized to withdraw the amount of [AMOUNT OF PERIODIC DEBIT] on a [PERIOD OF PAYMENT] basis on the [BILLING DATE] of each month, until we decide to cancel your services in respect to the terms and conditions we both agreed on. 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.