Reoccurring Automatic Bank Draft

Drafts are run on the 5th day of the month. If the 5th falls on a weekend or holiday, the drafts are then done on the following business day. We do not offer variable draft days.

By completing the form and submitting, you agree to the following: I understand that this authorization will be in effect until I notify my financial institution in writing that I no longer desire this service, allowing it reasonable time to act on my notification. I also understand that if corrections in the debit amount are necessary, it may involve an adjustment (credit or debit) to my account.

I have the right to stop payment of a debit entry by notifying my financial institution before the account is charged. If an erroneous debit entry is charged against my account, I have the right to have the amount of the entry credited to my account by my financial institution, if, within 15 calendar days following the date on which I was sent a statement of account or a written notice of such entry of 45 days after posting, whichever occurs first, I give my financial institution a written notice identifying the entry, stating that it is in error and requesting credit back to my account.


Community Name:*
Property Address: *
Month you would like draft to begin (we draft on the 5th):*
Amount to draft:*
Account Type:*
Bank Routing Number:*
Bank Account Number:*
Notes / Comments:
Attach a copy or photo of check: