Payment Authorization Form

Payment Authorization Form Template for Denmark

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Document background

The Payment Authorization Form is a fundamental document used in Danish financial transactions to establish formal permission for payment processing. It is required whenever an entity needs to obtain explicit authorization to initiate payments from an account holder's bank account, whether for single or recurring transactions. The form must comply with the Danish Payments Act, incorporating EU PSD2 requirements and GDPR considerations. It is commonly used for setting up direct debits, recurring subscription payments, or authorized one-time transactions. The document includes essential details such as account information, payment terms, data processing declarations, and authorization scope. It serves as a crucial tool for businesses and financial institutions in Denmark to ensure legally compliant payment processing while protecting both the payment initiator and the account holder.

Suggested Sections

1. Account Holder Information: Details of the individual or entity authorizing the payment, including full name, address, and contact information

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

3. Payment Details: Specification of payment amount, frequency (if recurring), and purpose of payment

4. Authorization Declaration: Clear statement of what the account holder is authorizing, including the specific permissions being granted

5. Data Protection Notice: GDPR-compliant statement about how the payment and personal data will be processed and stored

6. Termination Rights: Information about how to cancel or modify the payment authorization

7. Signature Block: Space for date and signature (whether electronic or physical)

Optional Sections

1. Direct Debit Mandate: Additional section required when the authorization is for direct debit payments, including SEPA mandate information

2. Third Party Authorization: Required when someone other than the account holder is authorized to manage the payment arrangements

3. Multiple Payment Schedule: Used when authorizing varying payment amounts or frequencies over time

4. International Payment Terms: Required for cross-border payment authorizations, including currency conversion terms

5. Corporate Authorization: Additional section for corporate accounts requiring proof of authority to sign

Suggested Schedules

1. Schedule A - Payment Schedule: Detailed breakdown of payment dates, amounts, and frequencies if payments are recurring

2. Schedule B - Terms and Conditions: Detailed terms and conditions of the payment service provider

3. Appendix 1 - Supporting Documentation: List of required supporting documents (ID verification, company registration, etc.)

4. Appendix 2 - Privacy Policy: Detailed privacy policy and data processing information as required by GDPR

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