Pre-Authorized Loan Payment
Authorization Form
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howardbank.com
To have your Howard Bank loan payments automatically debited from a Checking or Savings Account on its due date, return this form completed and signed.
• All payments, as described in the promissory note, and any monthly fees, will be debited on the payment due date.
• Return form to Howard Bank by mail, email, or fax:
Name of Borrower: Loan Account #: Date of 1
st
Auto Debit:
Regular Payment Amount: $
Additional Principal Amount: $ Total Draft Amount: $
I hereby authorize Howard Bank to initiate debit entries to my Checking or Savings Account indicated below, and direct the depository names below, hereinafter called DEPOSITORY, to
debit the same from the designated account.
Email: loanoperations@howardbank.com
Fax: 410-285-8524
Mail to ATTN: Loan Operations Department
3301 Boston Street
Baltimore, MD 21224
DEPOSITORY BANK INFORMATION
NON-HOWARD BANK ACCOUNTS
To have your loan payments paid from an account at another bank, fill out the fields below.
Name of Bank: Account #:
Name on Account: Transit/ABA #:
Address:
Account Type:
HOWARD BANK ACCOUNTS
To have your loan payments paid from a Howard Bank account,
fill out the fields below.
Account #:
Account Type:
Checking Savings
Check here if interest only
Checking Savings
HOWARD BANK LOAN INFORMATION
This authority is to remain in eect until (a) Howard Bank and Depository have recieved written notification from me of termination of this authorization in such time and in such manner
as to aord Howard Bank and Depository a reasonable opportunity to act on it, or (b) until my loan is paid in full.
Signature: Phone #: Date:
AUTHORIZATION
If the loan account has a monthly recurring fee, the automatic payment option in Fiserv must read “collect fees”
If external account, ensure description reads “HOWARD BK PYMT LN # (INSERT LOAN #)”
If additional amount is selected, int. meth. 2 & 7 will need to be modified to an int. meth. 1 or 6 with alternate payment schedule
BANK USE ONLY
Completed by: Date:
Edited by: Date:
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signature
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