Company Name: Farmers Insurance Exchange and its affiliates (members of the Farmers Insurance Group of Companies^®) (hereafter collectively referred to as “Farmers”)

I hereby agree to the terms and conditions of this authorization agreement as follows:

As the Named Insured, I hereby request and authorize Farmers to collect my insurance premiums and other amounts due from me to Farmers by debiting my financial institution account either electronically or by any other method, and I hereby request and authorize my financial institution to pay and charge such amounts to my account.

Farmers website may create a small data file, or “cookie”, on the hard drive of my computer in order to retain specific customer information.

I also understand that Farmers takes my security seriously and has implemented various measures designed to ensure the confidentiality of customer data, and protect against unauthorized access to or use of such information and that Farmers continually reviews and enhances its security systems, and is compliant with the rules and regulations governing the ACH network as established by NACHA- The Electronic Payment Association.

This authorization will remain in effect until Farmers has received written or online notification signifying termination of this agreement.

Mailing Address:
Farmers Insurance Exchange
6301 Owensmouth Avenue
Woodland Hills, CA 91367
ATTENTION: Online Billing Manager