Recurring Bank Debit Authorization Template

What is a recurring bank debit authorization?

Taking money straight from a customer's bank account every month is convenient for both sides — no chasing invoices, no forgotten card payments. But a bank debit is only fair, and only easy to defend if it's questioned, when the customer has clearly agreed to it in writing: how much, how often, from which account, starting when, and how they can stop it.

This authorization records exactly that. You describe what the payments are for, choose a fixed amount or the invoiced amount up to a cap, and set the frequency, debit day and first date. The debits can run until cancelled, until an end date or for a set number of payments. It holds the bank account details (or leaves them for the customer to write in), commits you to notice before any change, says what happens when a debit fails, and gives the customer a plain way to cancel and to have errors refunded.

When to use a recurring bank debit authorization

• A gym or studio collecting monthly membership fees by bank debit
• A lawn care or cleaning company setting up autopay for a service plan
• A private school or nursery taking termly or monthly fees
• A landlord or property manager collecting rent on the first of the month
• A business collecting agreed instalments on an outstanding balance

What you fill in

23 blanks, then the name and email of each person who signs: business, account holder.

What the recurring bank debit authorization covers

1. What the payments are for
2. Amount and schedule
3. Bank account
4. Changes and failed payments
5. Cancelling
6. Errors and records

Using the recurring bank debit authorization, step by step

1 Say what you're collecting

Describe what the payments are for — ideally pointing to the agreement or plan they belong to — and add the customer's account or membership reference so they can match the debits on their statement.

2 Set the amount and schedule

Pick a fixed amount, or the amount on each invoice with a maximum per debit. Choose weekly, fortnightly, monthly, quarterly or yearly, the debit day and the first date, then whether it runs until cancelled, to an end date or for a set number of payments.

3 Bank details, or leave them blank

Fill in the account holder, bank and account details if you already have them, or leave the number fields empty so the customer writes them in by hand. Many businesses prefer to collect account numbers over the phone or through their payment provider instead.

4 Notice, failures and send

Set how many days' notice you give before a change, how close to a debit the customer can cancel, whether you retry a failed debit, and any returned-payment fee. Then send it — the account holder signs first and you countersign.

Tips before you send it

• Your bank or payment processor may have its own mandate wording it insists on. If so, use theirs, or check this form covers what they need before relying on it.
• Send a reminder or invoice before each debit when the amount varies — customers dispute surprises, not bills they expected.
• The signed PDF holds bank details. In FileIt it is stored in your vault, so you don't need to keep paper copies lying around.
• Cancelling the debit doesn't cancel the debt. Keep the underlying service or payment agreement separate and signed too.

Recurring bank debit authorization: frequently asked questions

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This template is a general starting point, not legal advice. Laws differ between countries and states — have a lawyer review the agreement for your situation before you rely on it. Page last reviewed 2026-10-19.