ACH Application

ACH Application

Heritage at New Riverside, CA
AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS(ACH DEBITS)

This is for Heritage at New Riverside payments only
This application and appropriate copies must be received by the first (1st) of the month in which you wish DIRECT DRAFT to begin.
I (WE) hereby authorize Superior Management Services, LLC., agent for Heritage at New Riverside HOA herein after called COMPANY, to initiate debit entries and/or correction entries to our (check one): The funds must be drawn on a United States bank.
Account type

CHECKING ACCOUNTSAVINGS ACCOUNT
ALL DIRECT DRAFT TRANSFERS WILL BE DRAWN ON OR ABOUT THE 5TH OF EACH MONTH.
Bank / Depository Name
Branch
Branch's City, State
Bank Transit / ABA Number
Bank Account Number
Begin Direct Draft on

MonthDayYear
Date
This authorization is to remain in full force until COMPANY has received written notification from me, (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY reasonable opportunity to act upon it.
If you wish to stop direct draft you must notify Superior Management Services, LLC. in writing, including the date you would like services to be discontinued.
Owner 1

First NameLast Name
Owner 1 Phone Number
Please enter a valid phone number.
Owner 2

First NameLast Name
Owner 2 Phone Number
Please enter a valid phone number.
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Today's Date

MonthDayYear
Date
Signature Owner 1

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Signature Owner 2

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Please Upload a picture of a voided check from the account you wish to be drafted

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ALL DIRECT DRAFT TRANSFERS WILL BE DRAWN ON OR ABOUT THE 5TH OF EACH MONTH
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ACH Application

AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS(ACH DEBITS)