ACH Debit Form - ASPM San Diego

ACH Authorization For Withdrawal of Monthly Assessments

ACH is the auto-withdrawal by ASPM-SanDiego of homeowner monthly dues assessments. This payment option is offered free of charge to homeowners.

Homeowner Association Name*
Your Association Property Address, Including Unit #*
Street Address Unit # City ZIP Code
TERMS AGREED TO FOR AUTHORIZATION OF ACH WITHDRAWAL*

I hereby authorize the above-named Association to initiate debit entries to my Checking Account indicated below at the depository financial institution named below hereinafter called DEPOSITORY, and to debit the same to such account. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law.

I understand that submitting this form before the 25th day of the current month means that funds will be withdrawn from my account on the 5th day of the following month.

I understand that submitting this ACH Form after the 25th day of the month means I will need to make a one-time payment the following month until ACH begins on the second succeeding month after submission.

This authorization is to remain in full force and effect until ASPM-SanDiego receives written notification from me of its termination in such time and in such manner as to afford ASPM-SanDiego and my Financial Institution a reasonable opportunity to act on it.

I further acknowledge and agree to the terms, amounts, methods, and sources of withdrawal, as stated above.
Name of Financial Institution*
Branch Location of Financial Institution*
Monthly Debit Amount*
Monthly debit amount is subject to change with 30-day notice of approved dues increase or special assessment.
Bank Routing Number*
Confirm Bank Routing Number*
ASPM-SanDiego is not responsible for missed payments due to account information entered incorrectly.
Bank Account Number*
ASPM-SanDiego is not responsible for missed payments due to account information entered incorrectly.
Confirm Bank Account Number*
ASPM-SanDiego is not responsible for missed payments due to account information entered incorrectly.
Name on Bank Account*
First Last
Enter your name as it appears on your Checking Account.
ASPM Account # (If you know it, from the top right of your ASPM online account screen).
Please enter the best phone number (xxx) xxx-xxxx or email address to reach you in case there is a problem with your enrollment.*
Date*
Date Format: MM slash DD slash YYYY
MY NAME ENTERED BELOW CONSTITUTES MY SIGNED AGREEMENT TO WITHDRAW MONTHLY DUES ASSESSMENTS FROM MY BANK ACCOUNT.*
First Last
Name
This field is for validation purposes and should be left unchanged.