Banner Bank ACH Originator Guide

Instruction – Sample PPD Authorization for Recurring Debits

Authorization Sample: Your company can customize the authorization form to fit your specific application needs, but it must be readily identifiable as a payment authorization and at a minimum, include the following: • Acknowledgement that entries must comply with laws of the United States • Statement authorizing Originator to initiate credit or debit Entries • Account number and routing number of accounts • Identification of account type (i.e., checking, savings, loan, or general ledger) • Provisions for termination of the authorization • Individual identification (name and address are suggested) • Date and signature

Changing Date or Amounts: The Rules require you to notify your customers of any changes in date or amount debited under the following circumstances for consumer debits:

• Seven (7) calendar days’ notice for a change of date • Ten (10) calendar days’ notice for a change in amount

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