Direct Payment Plan
You can have your monthly dues payment made automatically from your checking or savings account every month. You authorize regularly scheduled payments to be made from your checking or savings account by filling out this form.

Payments will be withdrawn at the beginning each month. The authority you give to charge your account will remain in effect until you notify us in writing the terminate the authorization. Should the amount of your payment change, we will notify you at least 10 days before the next scheduled payment date.

Monthly HOA dues are $100

To take advantage of this service: complete this authorization form in its entirety. All information is kept confidential.

*Enrollment must be completed before the end of the month to have the withdrawal in the next month*
Name of Financial Instituion *
Your answer
Branch Address *
Your answer
Branch City *
Your answer
Branch State *
Your answer
Branch Zip Code *
Your answer
Type of Account *
Routing Number *
The routing number is usually the first set of numbers on a check. Check here for for info: http://www.nationwide.com/routing-and-account-numbers.jsp
Your answer
Bank Account Number *
The account number is usually the 2nd set of numbers on a check. Check here for more info: http://www.nationwide.com/routing-and-account-numbers.jsp
Your answer
Your Name *
Your answer
Your Address *
Your answer
Your Email
Your answer
Date *
MM
/
DD
/
YYYY
I affirm that the information I submitted is mine and is correct to the best of my knowledge. I would like to be set up for Direct Withdrawal according to the conditions explained above. *
Enrollment must be completed before the end of the month to have the withdrawal in the next month
Required
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