ACH (DIRECT DEBIT) FORM

Select One:   [  ] ADDITION                [  ] CHANGE                     [  ] DELETION     

You can now put your monthly association fee payments on "Automatic Debit" and save time and money. Electronic funds transfer is a process that allows you to make payment from your checking or savings account without writing a check. There is no additional charge for this service

If you would like to "Automatically" pay your monthly association fees, simply complete the authorization below and return this letter along with a voided check or deposit ticket from the account you would like this payment to be made from.***DO NOT USE A DEPOSIT SLIP IF PAYMENT WILL BE MADE FROM A CHECKING ACCOUNT.*** Please return both to the address listed on the bottom of this form.

COMMUNITY ___________________________________________________________________

NAME             ___________________________________UNIT NUMBER___________________

STREET ADDRESS_______________________________________________________________

CITY/STATE/ZIP   _______________________________________________________________

Until further written notice, by my/our signature (s) below, I/We authorize CFM Management Services to charge my/our:            [  ] Checking Account                                                  [  ] Savings Account  

I/We understand that the above checked account will be charged each month for my/our association fee payment. I/We understand that I/We should continue to remit payments until I/We receive written confirmation that automatic payments will begin. This authorization will remain in effect until revoked by me/us in writing.

DEPOSITARY (BANK) NAME______________________________________________________

ABA ROUTING#____________________My/OurACCOUNT#____________________________

SIGNATURE_____________________________ SIGNATURE____________________________

                                                                                                                        (If Joint Account)

DAYTIME PHONE #_______________________ E-MAIL______________________________

DON'T FORGET TO AFFIX A VOIDED CHECK TO THIS FORM.

www.CFMManagement.com.