Pre-Authorized Debit Agreement Template – Canada

Authorization Terms

The information provided here serves as a general example of an agreement allowing recurring bank payments. It is not intended to offer legal advice and should not replace consultation with a qualified legal professional experienced in financial arrangements or contractual obligations. Jurisdictional laws and regulations vary, and modifications may be necessary to ensure compliance with local requirements. The user assumes all responsibility for utilizing this example, and we accept no liability for errors, omissions, or consequences resulting from its use without professional legal review.

Please be advised: This document serves as a sample Pre-Authorized Debit Agreement specific to California. Actual terms may vary based on the agreement between the parties and applicable laws.

Sample Pre-Authorized Debit Agreement (CA)

Parties Involved:

Bank/Financial Institution: XYZ Bank
Address: 123 Finance Avenue, Los Angeles, CA 90001

Account Holder: John Doe
Address: 456 Maple Street, Los Angeles, CA 90002

Authorization for Pre-Authorized Debit:

The account holder authorizes XYZ Bank to debit the designated account, as specified below, for recurring payments as agreed upon in this document.

Payment Information:

Bank Name: XYZ Bank
Account Number: 123456789
Routing Number: 987654321
Payment Amount: $__________
Frequency: [Weekly/Monthly/Other]

Terms and Conditions:

• This authorization remains in effect until revoked in writing by the account holder.
• The account holder agrees to notify the bank of any changes to account details in advance.
• The bank will provide notice of any changes to the scheduled debits, as required by California law.

Los Angeles, ______________________