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AUTHORIZATION AGREEMENT
FOR PREAUTHORIZED PAYMENTS
Owner Name: _____________________________________
Unit # or ID #: _____________________________________
I (we) hereby authorize ________________________________
(Association Name) hereinafter called the COMPANY, to initialize
entries to my (our) checking account indicated below at the DEPOSITORY,
to debit the same to such account.
Homeowner's Bank Name:_____________________________________
Bank Address: ______________________________________________
_____________________________________________
Routing number or ABA number: _______________________________
Account number: _________________________________
DDA _____
SAV _____
Amount of dues to be paid:__________________________
Date due: 1st day of each ____________
(Month, Quarter, Year)
This authorization is to remain in
full force and effect until _______________________________________
(Association Name) has received written notification from me (or
either of us) of its termination in such time and in such manner
as to afford __________________________ and ________________________
(Association Bank) a reasonable opportunity to act on it.
_____________________________
_________________________
Signature of Homeowner
Signature of Homeowner
Date: ___________________________ Date:____________________
| Do not discontinue
making your maintenance payment via check until you receive
confirmation from our office as to the start date. |
Attention Homeowners: Whenever possible
provide the Association with a copy of a voided check to verify
bank information. Return or rejected preauthorized payments are
subject to late fees.
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