MAINTENANCE FEE “AUTO PAY” AUTHORIZATION
To participate in the Autopay program and have your association maintenance fees deducted automatically from your checking account, please fill out the information below and attach a voided check. If your Association is a sub-association within a master association, you will need to complete two separate applications.
Please complete each item below
And return completed form(s) with your voided check to:
Allied Property Management Group, Inc.
1711 Worthington Rd #103
West Palm Beach, FL 33409
ASSOCIATION NAME:______ACC’T #:______
UNIT OWNER NAME:______UNIT #:______
PROPERTY ADDRESS:______
CITY:______CONTACT NUMBERS(S):______
EMAIL ADDRESS:______
FINANCIAL INSTITUTION:______CHECKING:___ SAVINGS:___(CHECK ONE)
MONTH START DATE:______(AT LEAST 30 DAYS FROM DATE MAILED)
**I HEREBY AUTHORIZE MY FINANCIAL INSTITUTION TO DEBIT MY ACCOUNT IN THE NAME OF MY COMMUNITY ASSOCIATION FOR THE PURPOSE OF MAKING MY ASSOCIATION PAYMENTS AND
I UNDERSTAND THAT:
1. My account must have a zero balance due before Autopay will activate.
2. Notification of Autopay will be mailed to me to indicate enrollment has been successful. Until notification is received, continue to make your regular payments.
3. This debit will appear on my bank statement.
4. If I make payments for more than one unit and/or association, a separate form must be submitted for each.
5. The amount will change if amended by the Board of Directors
6. This Autopay is only for regular monthly or quarterly maintenance payments and not for special assessments that may be levied by the Board of Directors from time to time. They must be paid by check.
Autopay will not cease until written notification is received by Allied Property Management Group, Inc. at least 30 days prior to the next transaction effective date that you wish to cancel or otherwise change your Auto payment.
Signature:______Date:______
Office Use:
Date Received Date Entered Dated to Begin Notice Sent