Automatic Checking Deduction Authorization
This form authorizes a recurring charge to your checking account. Please make sure that all fields are complete.
We assume no responsibility for incorrect information provided herein.
 
Association "Originating Company"
 
The following Unit Owner authorizes the above named Originating Company to initiate debit entries and to initiate, if necessary, credit entries and adjustments for any debit entries to the account listed below. Unit Owner understands and agrees to have any recurring charges and all outstanding balances debited (deducted) periodically from the account listed below.
Unit Owner Name
Address
City
State Zip
Telephone
Email
Financial Institution Name
Address
Transit / ABA Number
City/State/Zip
Account Number
Account Type
Checking Savings
The Transit / ABA Number is the nine digit routing number that appears on the bottom of a check. Please make sure that all fields are complete. Check and verify that all bank information is correct. We assume no responsibility for incorrect information provided herein. Return or rejected ACHs are subject to late fees. The authority is to remain in full force until the Originating Company or Unit Owner has received written notification from the Unit Owner or Originating Company of its termination in such manner as to afford the Originating Company a reasonable opportunity to act on it.
Automatic Checking Deductions are accepted as a convenience to the Unit Owner and to the Association. The payment collected will be deposited to the checking account of your Association which is maintained with its bank, and will be reported to the Association immediately. The Unit Owner understands and agrees that any fees resulting from the noncollection of this payment due to disputes and/or chargebacks with the Unit Owner Owner's bank will be added to the Unit Owner's outstanding balance with the Association and might be reflected as non payment of the Association balance.