Direct Debit Authorization Form

Direct Debit Authorization Form Template for Indonesia

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Key Requirements PROMPT example:

"I need a Direct Debit Authorization Form for my company's electricity utility service in Indonesia, with fixed monthly payments of IDR 5,000,000 starting from March 2025, including clear cancellation terms and dual-language format (English and Bahasa Indonesia)."

Document background

The Direct Debit Authorization Form is a crucial document in Indonesia's banking system that facilitates automated payment arrangements between parties. It is used when an account holder wants to authorize regular, automatic payments to a specific merchant or service provider. The form must comply with Bank Indonesia regulations, particularly Regulation No. 22/23/PBI/2020 on Payment Systems and related consumer protection laws. The document contains essential information including account holder details, payment specifications, authorization terms, and cancellation rights. It's commonly used for recurring payments such as utility bills, insurance premiums, loan installments, or subscription services, providing a secure and efficient payment method while protecting both the customer's and merchant's interests under Indonesian law.

Suggested Sections

1. Account Holder Information: Details of the account holder including full name, address, and contact information as registered with the bank

2. Bank Account Details: Complete bank account information including account number, bank name, and branch details

3. Merchant/Billing Organization Details: Information about the organization authorized to initiate the direct debit

4. Authorization Declaration: Formal declaration authorizing the direct debit arrangement and confirming understanding of the terms

5. Direct Debit Amount and Frequency: Specification of payment amount (fixed or variable) and timing of debits

6. Duration of Authority: Period for which the direct debit authorization remains valid

7. Cancellation Rights: Terms and process for canceling the direct debit authorization

8. Signatures and Date: Space for account holder signature(s) and dating the document

Optional Sections

1. Secondary Account Holder Details: Required only for joint accounts where multiple signatures are needed

2. Variable Amount Authorization: Additional terms for cases where the debit amount may vary

3. Maximum Amount Limit: Optional ceiling amount for variable direct debits

4. Special Instructions: Any specific conditions or instructions for the direct debit processing

5. Electronic Authorization Consent: Required when the form is being completed electronically rather than in paper format

Suggested Schedules

1. Schedule A - Payment Details: Detailed breakdown of payment schedule, amounts, and specific dates if applicable

2. Schedule B - Terms and Conditions: Complete terms and conditions governing the direct debit arrangement

3. Schedule C - Bank's Rights and Obligations: Detailed explanation of the bank's role, rights, and responsibilities in processing the direct debit

4. Appendix 1 - Required Documentation: List of supporting documents required to be submitted with the authorization form

Authors

Alex Denne

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Banking and Financial Services

Insurance

Telecommunications

Utilities

Education

Real Estate

Subscription Services

Healthcare

Property Management

Retail

Relevant Teams

Legal

Finance

Compliance

Customer Service

Operations

Risk Management

Collections

Treasury

Account Management

Payment Processing

Relevant Roles

Finance Manager

Banking Operations Officer

Compliance Officer

Legal Counsel

Account Manager

Customer Service Representative

Payment Operations Manager

Treasury Manager

Financial Controller

Risk Management Officer

Collections Manager

Billing Administrator

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