Home Loan Credit Corporation – Direct Debit Authorization

Direct Debit Authorization

Home Loan Credit Corporation — please complete this form to authorize electronic (ACH) payments on your loan.
Borrower Information
Full Name

First NameLast Name
Email Address
Phone Number

Area CodePhone Number
Loan Number
Subject Property Address
Bank Account Information
Name(s) on Bank Account
Bank Name
Branch Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Account Type
Account Ownership
Company Name
Routing Number (ABA)
Bank Account Number
Confirm Account Number
⚠ The account numbers do not match. Please check both entries.
Payment Details
Payment Amount (USD)
Payment Type
Payment Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
First Debit Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Day of Month for Recurring Debit
Please indicate what day of the month you would like the payment processed
Authorization

I (we) authorize Home Loan Credit Corporation ("HLCC") to initiate electronic debit entries (ACH) to the bank account identified above, in the amount and on the schedule indicated on this form, for payments on the loan identified above. For recurring payments, debits will occur monthly on the day selected (or the next business day) beginning on the first debit date shown. I (we) also authorize HLCC, if necessary, to initiate entries to correct any erroneous debit. This authorization will remain in full force and effect until HLCC has received written notification from me (us) of its termination in such time and manner as to afford HLCC and my (our) bank a reasonable opportunity to act on it. I (we) understand that a copy of this authorization will be provided to me (us).
Agreement
Authorization Signature
Date of Authorization

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Direct Debit Authorization

Borrower Information

Bank Account Information

Payment Details

Authorization