Pre Authorized Debit Form Template (Free PDF Generator)

Welcome to our Pre Authorized Debit authorization form generator!

A Pre Authorized Debit (PAD) form is an agreement that outlines payment terms between you and your customers for pre authorized bank payments. We offer a free tool to download your own blank PAD form PDF.

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Complete the required fields to get your blank Pre Authorized Debit form.

How to use the free PAD authorization generator

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Step 1

Edit the required business information in the generator

download Pre Authorized Debit form template

Step 2

Download the blank Pre Authorized Debit form

Print Pre Authorized Debit form template

Step 3

Print the authorization form for your customers to fill out

Learn about ACH authorization and payments

Read our ultimate guide to Pre Authorized Debit payments

We’ll take you through all the details of Pre Authorized Debit payments, an electronic fund transfer from one bank to another.

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Pre Authorized Debit FAQs

A Pre Authorized Debit form is a legal form that outlines the payment terms between a payor and a payee. It is a requirement for collecting payments over Canada's EFT network.

To collect payments directly from a customer’s bank account over the EFT network, you need permission from your customers. A properly formatted Pre Authorized Debit form is the way to gain this permission.

Authorization can be collected online as well as on paper (and even over the phone). There are specific requirements for online Pre Authorized Debit forms. Most businesses that facilitate Pre Authorized Debit payments online use a third-party payment provider like Rotessa.

Upon downloading your Pre Authorized Debit form, give the form to your customer to fill out. Once your customer has filled out all of the necessary fields this form can be used to automate payments over the EFT network. You can access the EFT network from your bank or a third party Pre Authorized Debit provider like Rotessa.

Yes. If a customer gives you notification that they want to cancel an authorization their request must be honored. This is according to Payments Canada regulations.

A Pre Authorized Debit form requires the following elements:
1) Your contact information
2) Payor’s name
3) Payor’s bank branch transit number
4) Payor’s bank account number
5) Payor’s institution ID number
6) Amount and timing (for recurring and one-time payments)
7) Authorization statement
8) Cancelation details
9) Recourse statement
10) Date of agreement and signature (if a physical paper form)
This Pre Authorized Debit form template has all of these requirements.

No, this authorization form can only be used for debiting payments through the EFT network.

Sample Pre Authorized Debit forms (built with our generator)