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The ACH Authorization Form is a critical document used in Indonesia's financial ecosystem to establish automated payment arrangements between parties. This document is essential when setting up recurring payments, direct debits, or regular fund transfers through the Indonesian banking system. The form must comply with Bank Indonesia Regulation No. 19/8/PBI/2017 on the National Payment Gateway and related regulations governing electronic payments. It typically contains the account holder's banking information, specific payment details, authorization terms, and consent declarations. The ACH Authorization Form serves as a legal record of the account holder's permission for automated transactions and includes necessary provisions for modification or cancellation of the authorization.

1. Account Holder Information: Details of the account holder including full legal name, address, and contact information as required by Indonesian banking regulations

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

3. Payment Authorization: Express authorization for ACH debits, including the purpose of the payments and confirmation that the account holder has the right to authorize payments from the account

4. Payment Details: Specific information about the authorized payments including amount (fixed or maximum), frequency, and start date

5. Duration of Authorization: Statement of how long the authorization remains valid and conditions for termination

6. Cancellation Rights: Information about the account holder's right to cancel the authorization and the required notice period as per Indonesian regulations

7. Signature Block: Space for date and signature of the account holder, with certification of authority