BHFC AutoWithdrawal Check

BHFC Financial Services (602) 548-1615

customerservice@bhfcfinancial.com -- 7017 N 56th Ave Glendale AZ 85301
Authorization for Automatic Check Withdrawal
With your written authorization, BHFC can make paying your monthly payment a bit easier by automatically withdrawing payments from your checking account. If you choose to pay by automatic withdrawal, BHFC will generate a check covering the period you select. Just complete this authorization, sign it, and return it to BHFC. BHFC will sequence your checks starting with check number 1, and continuing thereafter for the number of payments to be made. Upon receipt of your authorization, BHFC will email you when the withdrawal has been set up. There is no charge for automatic withdrawal by check.
Customer Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Customer E-mail
Phone Number*
Cell Number (May be used to Text you)*
I hereby appoint BHFC as my agent to duplicate, mechanically sign (as my agent), and forward for deposit into BHFC’s bank account a check drawn on my checking account for the time interval and/or amount I have chosen (check only one):
Choose ONE:*

Monthly-- one monthly payment per check (12 payments/year) on the DAY ENTERED BELOW, of each month (if left blank, BHFC will deposit the check on the contractual due date).BI-WEEKLY—(payment every other week—(26 payments/year): ½ of monthly payment per check starting on the DATE ENTERED BELOW, and continuing every 2 weeks (14 days) thereafter.WEEKLY—(payment of 1/52nd of annual payment per week—(4 payments/Month): on the DATE ENTERED BELOW and every 7 days thereafter.
Date(s) to Start Withdwawal
Unless the box is filled below, the amount BHFC will withdrawal each period will be according to the schedule above, where you checked monthly, bi-weekly or weekly. Example If your monthly payment was 400 and you select bi-weekly above ever other week, $200 will be withdrawn from your account. If you would like to pay ADDITIONAL FUNDS EACH WITHDRAWAL toward you loan, please enter that below.
Additional Withdrawal Amount
Bank Name*
Bank Routing Number*
Must be 9 digits
Bank Account Number*
I represent that the account has not been closed and that I will advise BHFC any time I change account numbers or banks. I understand that all checks are required to be covered by sufficient funds in the bank account on which the check is drawn and that BHFC will not resubmit insufficient funds checks to the bank. I further understand that there is a $25.00 charge (or amount allowed by Local Law) for any returned check, and that if there are more than 2 returned checks, BHFC may require all of my future payments to be made by cashier’s check, money order, or Western Union Quick Collect®.
Should be Empty:

BHFC Financial Services (602) 548-1615

Authorization for Automatic Check Withdrawal