Pre-Authorized Payment, Specific Amount [DATE, ex. Wednesday, June 11, 1998] [NAME, COMPANY AND ADDRESS, ex. John Smith XYZ Bank 1234 First Street Suite 567 Anycity, Anystate 85245] Dear [NAME, ex. John Smith], You are hereby authorized to withdraw from the following account the amount of [AMOUNT OF PERIODIC DEBIT, ex. $4,299.48] on a [PERIOD OF […]
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