MELISSA A. CAOUETTE
STANDING CHAPTER 13 TRUSTEE
400 N. Saginaw St. Ste. 331
Flint, Michigan
48502-2045
                         Telephone (810) 238-4675
  Fax (810) 238-4712

Authorization for Preauthorized Variable Withdrawals (ACH Debits)

I hereby authorize THE CHAPTER 13 TRUSTEE AT Flint, MICHIGAN
to make withdrawals from time to time from the account identified below at ____________________________________________
PHONE # of Financial Institution _______________________ (Depository Financial Institution, hereinafter referred to as DFI) and authorized the DFI to charge such withdrawals to my listed account.

Debtor’s Name:________________________________________________Phone# _______________________________

Case No.: _______________________________________ Attorney Name/Phone#__________________________________

Source of Deposits: (Check One)
        Payment to be taken on the 5th of the month.   $___________
                                     OR
               Payment to be taken on the 22th of the month  $___________

               To have Semimonthly withdrawals check 2 boxes

I understand that the EXACT sum must be available for withdrawal.  If the exact sum is not available, NONE of the funds available will be transmitted to the Trustee. In addition, I understand that if funds are not available in the exact amount a non-sufficient funds charge will be charged against my account.

If the purpose for withdrawal is restricted in any manner, such restriction is stated below. Adjust entries to correct errors are also authorized. It is agreed that these withdrawals and adjustments may be made electronically and under the Rules of the Michigan Automated Clearing House Association. This authorization will remain in effect until written notice of termination is given to the Trustee. I acknowledge receipt of a filed copy of this Authorization.

Name of DFI		DFI’s Routing & Transit No.		Account No. to Debit	Type of Account
            CHECKING
               SAVINGS	
Name of Authorizing Party (Please Print)			Address	City	State	Zip Code	
Signature of Authorizing Party	Date			
Amount Per Month

$                                                             or amount as amended per order of Bankruptcy Court	

Please Attach Voided Check To This Authorization.
Please Contact Your Bank or Credit Union to Determine If Additional
Numbers Have To Be Added To Your Account Number To Allow For The Electronic Withdrawal.