Pre-Authorized Payment Specific Amount Template

Download this Pre-Authorized Payment Specific Amount Template Design in Google Docs, Word, PDF, Apple Pages, Outlook Format. Easily Editable, Printable, Downloadable.

Is there a specific amount of money you want the bank to automatically debit from your account on a certain basis? If that is the case, then be sure to make good use of our Pre-Authorized Payment Specific Amount Template. Professionalism is the one word you can use to describe this well-made template. Benefit from its ease of use, customizability, and versatility; this is simple in terms of design, although the layouts and formatting remain impressive to see nonetheless. Any edits you want to make can be easily implemented, and the choices in file formats allows for its versatility to shine through. Download this template today while it is still available!

PRE-AUTHORIZED PAYMENT SPECIFIC AMOUNT

[DATE]

Dear [RECIPIENT NAME],

This letter is to formally notify you that we are authorizing [COMPANY NAME] to withdraw an amount of $[NUMBER] for a period of [NUMBER 1] months from [START DATE] to [END DATE] . This amount shall be withdrawn every [NUMBER 2] of the month on a [PERIOD] basis until, upon reaching a mutual agreement, the decision to cease your services will be met.

Enclosed within this letter is a blank check taken from the bank account labeled [TITLE]. Also, this letter serves as your authority to allow aforementioned company to carry out [HIS/HER] transactions with the bank account below:

Bank: [DETAIL]
Bank Transit No: [NUMBER 3]
Account No: [NUMBER 4]
Bank Tel. No. [NUMBER 5]
Bank Contact [DETAIL 1]

Thank you very much for your cooperation. Feel free to reach us at [PHONE NUMBER] or email us at [EMAIL ID].

Regards,

[YOUR SIGNATURE]

[YOUR NAME]