Number Number. ARTICLES
Number Number. This authorization is to remain in full force and effect 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 has reasonable opportunity to act on it. Name (Print Name) Date Escrow Number Signature
Number Number. This authorization is to remain in full force and effect until COMPANY has received written notification from me of its termination in such time, and in such manner as to afford COMPANY and Financial Institution a reasonable opportunity to act on it. Name (Please Print) Signature
Number Number. This authorization is to remain in full force and effect 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 opportunity to act on it. Name(s) (Please Print) Date Signature Phone Email _ NOTE: AUTHORIZATION MUST PROVIDE THAT THE RECEIVER MAY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION. A NEW FORM MUST BE COMPLETED EVERY FISCAL YEAR BY AUGUST 31. IF NO FORM IS RECEIVED BY THAT DATE, OR ACCOUNT IS INACTIVE FOR THE PREVIOUS FISCAL YEAR, THE ACCOUNT WILL BE CLOSED.
Number Number. This authorization is to remain in full force and effect until Forest Lake Education Center has received written notification from me (or either or us) of its termination in such time and in such manner as to afford Forest Lake Education Center and First Colony Bank a reasonable opportunity to act on it. Name(s) _ (Please Print) Date _ Signature NOTE: • A VOIDED CHECK IS REQUIRED. • PLEASE ALLOW FOR 6 BUSINESS DAYS FROM THE TIME OF TURNING IN THIS FORM AT THE ACCOUNTANT OFFICE, FOR THE INITIAL DEBIT TO OCCUR.
Number Number. This authorization is to remain in full force and effect 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 a reasonable opportunity to act on it. Depositor Name Club # Signature Date Name & Title Signature Date Name & Title NOTE: ALL WRITTEN DEBIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MAY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION. Account holder is required to verify bank account data and attach a voided check here.
Number Number. This authorization is to remain in full force and effect 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 a reasonable opportunity to act on it. Name(s) Member Number (Please Print) Date Signature NOTE: ALL DEBIT AUTHORIZATION MUST PROVIDE THAT THE RECEIVER MAY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION. Hollx Hills Countrx Club 0000 XxxxxxxxX Xxxx Ijamsville, MaRyland 21754
Number Number. This authorization is to remain in full force and effect until Company has received written notification from me(or either of us) of its termination in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it. City Information: Name on City Acct.: City Acct. Number(s) Signature(s) Signature(s) Date: Date:
Number Number. This authorization is to remain in full force and effect until CITY UTILITIES has received written notification from me (or either of us) of its termination in such time and in such manner as to afford RUSHVILLE CITY UTILITIES and DEPOSITORY a reasonable opportunity to act on it. Name(S) Date (Please Print) NOTE: ALL WRITTEN DEBIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MAY REVOKE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION. All accounts will be debited on the 5th day of each month. All ACH customers will be sent a notice each month for your records. All accounts will be debited for the exact amount of the bill each month. I (we) have read and understand the above statements. Signature Signature
Number Number. This authorization is to remain in full force and effect 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 a reasonable opportunity to act on it. Name(s) ID Number Date Signature NOTE: ALL WRITTEN DEBIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MAY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION. Email Address: Unit #: Amount of monthly fee: Phone # (s): Start Month: Special Assessments / Additional Charges Circle One: YES/NO Notes: ***A Voided Check Must Be Attached*** We offer this service to the homeowners for automatic bank draft for the monthly regime fee and any special assessment fees as noted. Please contact Xxxxxxxxx Xxxxxx should you have any questions: xxxxxxxxx@xxxxxxxxxxxxx.xxx
