AUTHORIZATION TO DEBIT ACCOUNT
[DATE, ex. Wednesday, June 11, 1998]
[NAME, Bank AND ADDRESS, ex.
1234 First Street
Anycity, Anystate 85245]
Dear [NAME, ex. John Smith],
You are hereby authorized and directed to debit our account no. [ACCOUNT NUMBER, ex. 12345678] in the amount of [AMOUNT OF DEBIT, ex. $8,236.09] in payment of [NATURE OF DEBIT, ex. your loan commitment fee].
This shall be your good and sufficient authority for so doing.
[NOTE: IF MORE THAN ON SIGNATURE IS REQUIRED ON ACCOUNT, MAKE SURE BOTH BANK SIGNING OFFICERS SIGN LETTER]
[YOUR NAME, ex. Jill Jones]