Forest Oaks II HOA - ACH Authorization Form

AUTHORIZATION FOR ACH ORIGINATION

Date

Owner’s Name

Email Address (for confirmation)

Optional. If provided, you will receive a confirmation email.

Phone Number (optional)

I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.

I (we) hereby authorize Forest Oaks II Homeowners Association to initiate to my (our) checking/savings accounts at the financial institution listed below and, if necessary, initiate adjustments for any transactions credited/debited in error. This authority will remain in effect until Forest Oaks II Homeowners Association is notified by me (us) in writing to cancel it in such time as to afford Forest Oaks II Homeowners Association Bank and the owner(s) a reasonable opportunity to act on it. Compliant with the ACH Operating Rules of the NACHA, I authorize the transfer.

Name of Financial Institution

Financial Institution Phone Number

Address of Financial Institution (Branch, City, State & Zip)

Financial Institution Routing Number

Checking or Savings Account Number

Account Type (circle account type)

Checking Savings

Amount

Dues amount remains in effect unless Forest Oaks II Homeowners Association Board votes to increase monthly dues based on annual reviews. Written notice of any increase in dues will be provided to owners at least 10 calendar days in advance of the debit and will be effective each month thereafter.

Frequency

Start Date (if recurring)

Debit(s) will be made the 1st banking day of each month.

If the debit is recurring and the date of the debit falls on a non-banking day, the debit will hit your account on the next banking business day and will not hit your account prior to the authorized date.

Signatures

Signature (Typed)

Signature

Date

Signature (Typed) - Optional 2nd Signature

Signature

Date (Optional)

Date

Name – Please Print

Name – Please Print (Optional)