Fillable AuthorizationtoPayOutstandingChecks AUTHORIZATION TO PAY OUTSTANDING CHECKS AND ACHs

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AuthorizationtoPayOutstandingChecks AUTHORIZATION TO PAY OUTSTANDING CHECKS AND ACHs

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The AuthorizationtoPayOutstandingChecks AUTHORIZATION TO PAY OUTSTANDING CHECKS AND ACHs form is 1 page long and contains:

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  • 4 check-boxes
  • 66 other fields

Country of origin: US
File type: PDF

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Scan and attach to Salesforce case Rev. 04/19
AUTHORIZATION TO PAY
OUTSTANDING CHECKS AND ACHs
Date
Time
Account Holder Name
Old Checking Acct #
(MUST BE CLOSED)
New Checking Acct #
I AUTHORIZE FLAGSTAR BANK TO PAY: Please select ONLY the boxes that apply.
ALL CHECKS drawn on my old account against my new account.
ALL ACH CREDITS deposited to my old account to be credited to my new account.
ALL ACH DEBITS drawn on my old account against my new account.
ONLY SPECIFIED BELOW (please specify): Checks and/or ACH Debits specified below drawn on or incoming to my old
account against my new account.
Check Number Amount Payable to/Received From
Account Owner Signature
X
Date
Account Owner Signature
X
Date
Branch Employee Name Printed
X
Branch Employee Signature
X
Branch Number
Date
(For Branch Use Only) Instructions: Please ensure that the old account is closed prior to opening a Salesforce case. This form
must be attached to the Salesforce case at the time of opening to be able to process the authorization to pay. To pay
outstanding checks, either box #1 (all) or box #4 (specific) can be selected, not both. To pay outstanding ACH credits select box
#2. To pay outstanding ACH debits select box #3 (all) or box #4 (specific). If there are specified ACHs to pay, box #3 cannot be
selected. Lack of proper completion of this form can result in closure of the Salesforce case and therefore a delay in processing
of the authorization to pay.
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AuthorizationtoPayOutstandingChecks AUTHORIZATION TO PAY OUTSTANDING CHECKS AND ACHs

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Completed 3 July 2020

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