2024 Monthly Payment Agreement

This form is intended for LMOA members who want to take advantage of our payment plan and agree to pay their annual dues on a monthly basis. All payments must be received on or before the last business day of every month.

If you have a balance forward showing on your statement - you must include that amount in your first payment in order to be approved for this agreement.

Only members in good standing qualify for the 2024 monthly payment plan. Please note that a monthly installment fee of $5.00 per lot will be billed to your account each month, and is included in your monthly payment total below.

Name (as it appears on your photo ID)*

First NameLast Name

Email*

example@example.com

Phone Number:*

Please enter a daytime phone number

Billing address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please enter LMOA property street address(es). Be sure to Click 'Save To Form' after entering each address:*

I am opting for the following monthly payment plan:*

Personal check via USPS mailPay online using LMOA.ORG Bill Payment (ACH/CC)

By signing below, I hereby acknowledge that I am choosing to pay LMOA 2024 annual dues monthly as indicated in my option above. This agreement will remain in effect until paid in full or until December 31, 2024, whichever occurs first. I understand that a $35 fee will be charged to my account if a payment is returned for any reason. Personal checks shall be made payable and mailed to Lake Monticello Owners' Association, 41 Ashlawn Boulevard, Palmyra, VA 22963, or left in the drop box at the same address. If you have questions regarding your account, please contact 434-589-8263.

Signature*