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Direct Payment Form Template for United States

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Direct Payment Form

"I need a Direct Payment Form to set up monthly automatic payments of $2,500 from my business account to our office landlord, starting from March 2025, with the option to modify the payment amount annually based on lease terms."

Document background
The Direct Payment Form serves as a crucial document in modern banking transactions within the United States. It enables automated payments while ensuring compliance with federal and state banking regulations. This form is essential when establishing recurring payments, one-time authorized withdrawals, or automated clearing house (ACH) transfers. The document includes critical information such as bank account details, payment schedules, and authorization terms, while incorporating necessary safeguards required by U.S. banking laws and the Electronic Fund Transfer Act.
Suggested Sections

1. Account Holder Information: Personal/business details of the account holder including name, address, contact information, and tax identification numbers

2. Bank Account Details: Banking information including bank name, routing number, account number, and account type

3. Payment Authorization: Explicit authorization statement for direct payments including acknowledgment of rights and responsibilities

4. Payment Details: Specific information about the payment including amount, frequency, start date, and duration

5. Terms and Conditions: Standard terms governing the direct payment arrangement including cancellation rights and processing timeframes

Optional Sections

1. Secondary Account Details: Backup account information to be used in case primary payment method fails

2. International Transfer Details: Additional information required for international payments including SWIFT codes and corresponding bank details

3. Corporate Authorization: Additional authorization requirements and documentation for corporate accounts

Suggested Schedules

1. Schedule A - Payment Schedule: Detailed breakdown of payment dates, amounts, and any variable payment calculations

2. Schedule B - Terms and Conditions: Comprehensive terms and conditions including rights, obligations, and regulatory disclosures

3. Appendix 1 - Supporting Documentation: Required supporting documents such as voided check or bank verification letter

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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Industries

Electronic Fund Transfer Act (EFTA): Federal law that establishes the basic rights, liabilities, and responsibilities of consumers who use electronic fund transfer services and of financial institutions that offer these services

Regulation E: Federal regulation implementing the EFTA, providing a framework for establishing rights, liabilities, and responsibilities of participants in electronic fund transfer systems

UCC Article 4A: Uniform Commercial Code article governing wholesale wire transfers between businesses and financial institutions

Bank Secrecy Act (BSA): Federal law requiring financial institutions to assist government agencies in detecting and preventing money laundering

USA PATRIOT Act: Federal law that includes provisions for customer identity verification requirements in financial transactions

Gramm-Leach-Bliley Act (GLBA): Federal law that requires financial institutions to explain their information-sharing practices to customers and protect sensitive data

Consumer Financial Protection Bureau Regulations: Federal regulations governing consumer financial products and services, including payment processing and consumer protections

Fair Credit Reporting Act: Federal law that regulates the collection and use of consumer credit information

State Banking Regulations: Varying state-specific laws governing banking operations and financial transactions within individual states

State Electronic Transaction Laws: State-specific laws governing electronic transactions and digital signatures

State Privacy Laws: State-specific regulations governing the protection and handling of personal information

State Consumer Protection Laws: State-specific laws designed to protect consumers from unfair or deceptive business practices

NACHA Rules: Operating rules for the ACH Network, governing the exchange and settlement of electronic financial transactions

Federal Reserve Requirements: Regulations and standards set by the Federal Reserve for financial transactions and banking operations

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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