Pay My Land ACH Authorization

Fill in below to Add or Remove a Name on Your Contract
Date on Contract

MonthDayYear
(See Purchase and Sale Agreement Page 1)
Today's Date

MonthDayYear
Payment Amount
Monthly amount to be drafted including Property Taxes
Account Type
I would like to
Farm Location*
Your Farm Location
Farm Number*
Your Farm Number
How many Buyers are on your existing Contract?*
How many additional Buyers are you adding?*
How many Buyers are you Removing?*

Existing Buyer 1 Name*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to add the buyer(s) listed below to my Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed shall be in all authorized names, including this added name(s).
By signing below, I am authorizing Pay My Land Inc. to remove the buyer(s) listed below from the Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed will not be Deeded to anyone not listed on the Purchase and Sale Agreement. Additionally, all removed persons have relinquished all property rights and liabilities from the Purchase and Sale Agreement.
Existing Buyer 1 Signature*

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Existing Buyer 2 Name*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to add the buyer(s) listed below to my Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed shall be in all authorized names, including this added name(s).
By signing below, I am authorizing Pay My Land Inc. to remove the buyer(s) listed below from the Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed will not be Deeded to anyone not listed on the Purchase and Sale Agreement. Additionally, all removed persons have relinquished all property rights and liabilities from the Purchase and Sale Agreement.
Existing Buyer 2 Signature*

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Existing Buyer 3 Name*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to add the buyer(s) listed below to my Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed shall be in all authorized names, including this added name(s).
By signing below, I am authorizing Pay My Land Inc. to remove the buyer(s) listed below from the Purchase and Sale Agreement for {farmLocation15}, Farm {farmNumber}. The Property Deed will not be Deeded to anyone not listed on the Purchase and Sale Agreement. Additionally, all removed persons have relinquished all property rights and liabilities from the Purchase and Sale Agreement.
Existing Buyer 3 Signature*

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Buyer A to be added*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to add my name to a certain Purchase and Sale Agreement for Farm {farmLocation15}, {farmNumber}, dated {dateOn18}. I understand and agree that I have reviewed the Purchase and Sale Agreement and acknowledge all rights and liabilities associated with said Purchase and Sale Agreement.
Signature of Buyer A to be added*

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Buyer B to be added*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to add my name to a certain Purchase and Sale Agreement for Farm {farmLocation15}, {farmNumber}, dated {dateOn18}. I understand and agree that I have reviewed the Purchase and Sale Agreement and acknowledge all rights and liabilities associated with said Purchase and Sale Agreement.
Signature of Buyer B to be added*

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Buyer 1 to be removed*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to remove my name from a certain Purchase and Sale Agreement for Farm {farmLocation15}, {farmNumber}, dated {dateOn18}. I understand and agree that I am relinqueshing all rights and liabilities associated with said Purchase and Sale Agreement.
Signature of Buyer 1 to be removed*

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Buyer 2 to be removed*

First NameMiddle NameLast Name
By signing below, I am authorizing Pay My Land Inc. to remove my name from a certain Purchase and Sale Agreement for Farm {farmLocation15}, {farmNumber}, dated {dateOn18}. I understand and agree that I am relinqueshing all rights and liabilities associated with said Purchase and Sale Agreement.
Signature of Buyer 2 to be removed*

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Existing Buyer Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Existing Buyer Email Address*

Confirmation Email
Existing Buyer Primary Phone
Blank Check Photo

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Customer Signature

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Fill in below to Add or Remove a Name on Your Contract