Pre-Authorized Service Agreement

Assesment Explanation

How do Pre- Authorized Charges Work?

Pre-authorized charges to your account will be processed, on or about the 6th day of each month, for the amount of your regular monthly assessment payment. Payments so collected will be deposited to the checking/savings account of your ASSOCIATION, maintained with Community Association Banc.

There may be changes to the assessment amounts and/or due dates in accordance with the ASSOCIATION’S governing documents and applicable statutes including notification requirements of the ACH (Automated Clearing House) rules.

We reserve the right to make changes in the agreement at any time. We may cancel Preauthorized Electronic Assessment Payments at any time without cause and you can terminate this agreement at any time by giving sufficient written notice or by closing the designated accounts.

Violation Report Form

Use this form to report a rules violation in your community. Your message will be kept confidential unless you are needed to testify before the executive board. Before the board can act upon any violation to the Rules and Regulations, all violations must be documented in writing or electronically submitted. This form must be completed and sent to the Management Office before any action is taken.

Today's Date*
MM
DD
YYYY

Make sure to enter today's date. Your submission will not work unless you do.
Your Name*
First Last
Email*
Phone*
Your Community Name*
Your property manager's name is:
Address*
Street Address City State ZIP Code
Name of offending party
First Last
If you know their name that really helps us.
Address of Offending Party*
Street Address City ZIP Code
Date violation occured (if known)
MM
DD
YYYY
Please state the nature of the violation*
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By Checking the box below I hereby attest that the information is true to the best of my knowledge and I am willing to participate with the Executive Board on this action in acting as a witness, if necessary.*
- I agree to the above statement
Phone
This field is for validation purposes and should be left unchanged.

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Preauthorized Electronic Assessment Payment Service Agreement & Disclosure:*
- I have read this statement
Preauthorized Electronic Assessment Payment Service Agreement & Disclosure: Preauthorized charges to your account will be processed, on or about the 6th day of each month, for the amount of your regular monthly assessment payment. Payments so collected will be deposited to the checking/savings account of your ASSOCIATION, maintained with Community Association Banc. There may be changes to the assessment amounts and/or due dates in accordance with the ASSOCIATION’S governing documents and applicable statutes including notification requirements of the ACH (Automated Clearing House) rules. We reserve the right to make changes in the agreement at any time. We may cancel Preauthorized Electronic Assessment Payments at any time without cause and you can terminate this agreement at any time by giving sufficient written notice or by closing the designated accounts.
Name
First Last
Email*
Phone*
Association Name*
Address*
Street Address City State ZIP Code
My Signature Authorization*
- I agree
- I do not agree
I hereby authorize my association and/or Acri Commercial Realty, Inc., as Agent, to directly debit my checking/savings/charge account on or about the 6th day of each month at the financial institution indicated above for my monthly payment. Such direct debit will be made on each succeeding month, unless I choose to terminate this agreement in writing. Any such notification shall become effective following receipt, after a reasonable opportunity to act on it. You must check I agree in the check box above. Checking I agree serves as your approval to begin this electronic debit service to begin in the manner described above.
Method of Payment*
Start Month*
I (we) hereby authorize Acri Commercial Realty, Inc. hereinafter referred to as MANAGER, as agent for the association named above to initiate debit entries to my CHECKING/SAVINGS account at the depository named below, hereinafter referred to as DEPOSITORY, to debit the same to such account.
Depository Name*
This authority is granted in accordance with the terms and conditions of the MANAGERS Preauthorized Electronic Assessment Payment Service Agreement & Disclosure Statement receipt of which I hereby acknowledge. This authority is to remain in full force and effect until MANAGER has received written notification from me (or either of us) of its termination in such manner as to afford MANAGER a reasonable opportunity to act on it.
Routing Number*
Your bank routing number is a nine-digit code that's based on the U.S. Bank location where your account was opened. It's the first set of numbers printed on the bottom of your checks, on the left side
Account Number*
Your account number (usually 10-12 digits) is specific to your personal account. It's the second set of numbers printed on the bottom of your checks, just to the right of the bank routing number. You can also find your account number on your monthly statement. - See more at: https://www.usbank.com/bank-accounts/checking-accounts/aba-routing-number.aspx#sthash.kGVLxJPC.dpuf
Bank Account Number*
Pre-authorized Payment Service Agreement Disclosure Statement*
- I agree
Preauthorized Electronic Assessment Payment Service Agreement & Disclosure: Preauthorized charges to your account will be processed, on or about the 6th day of each month, for the amount of your regular monthly assessment payment. Payments so collected will be deposited to the checking/savings account of your ASSOCIATION, maintained with Community Association Banc. There may be changes to the assessment amounts and/or due dates in accordance with the ASSOCIATION’S governing documents and applicable statutes including notification requirements of the ACH (Automated Clearing House) rules. We reserve the right to make changes in the agreement at any time. We may cancel Preauthorized Electronic Assessment Payments at any time without cause and you can terminate this agreement at any time by giving sufficient written notice or by closing the designated accounts.
Type in your Signature*
This serves as your electronic Signature Approval
Date*
Date Format: MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.