Electronic Fund Transfer Authorization Agreement

Adobe Acrobat Reader is required to view, fill out and print forms. To incorporate the most recent accessibility features download of the latest version of Acrobat Reader may be required. If you have problems with Acrobat Reader or our PDF form, select PDF Troubleshooting.

This form must be completed by an authorized representative of the BWU. This form authorizes DMV to debit payment of fees to DMV for transactions completed by the BWU.  When submitting this form to the BWU Program, please remember to include a Voided Check for verification of the account and routing numbers.

Electronic Fund Transfer Authorization Agreement (PDF)

Back to main BWU page.