I (we) hereby authorize Hidden Forest Homeowners Association to electronically debit credit my (our) account (and, if necessary, electronically credit my (our) account to correct erroneous debits1) as follows:

Depository Name

Routing Number

Account Number

Name(s) on the Account

Address on ACH Account

Hidden Forest Address

Phone Number

Amount of debit or method of determining amount of debit(s): Current Assessment amount as posted on Hidden Forest Website and/or printed on your assessment bill.

Your account will be drafted the current assessment October 1 (or first business day) and the current assessment April 1 (or first business day).

I (we) understand that this authorization will remain in full force and effect until I (we) notify Hidden Forest Homeowners Association in writing or by phone that I (we) wish to revoke this authorization.
I (we) understand that COMPANY requires at least 30 days prior notice in order to cancel this authorization.
Notice can be given in person or at the office location as well as via email to hfho@hiddenforesthoa.com

Name(s)

Date

Signature(s)

The NACHA Operating Rules do not require Customer’s express authorization to initiate Reversing Entries to correct erroneous transactions. However, Originators should consider obtaining express authorization of debits or credits to correct errors.

Written credit authorizations must provide that the Receiver may revoke the authorization only by notifying the Originator in the time and manner dated in the authorization. The reference to notification should be filed with a statement of the time and manner that notification must be given in order to provide company a reasonable opportunity to act on it (e.g., “In writing by mail to 100 Main Street, Anytown, NY that is received at least three (3) days prior to the proposed effective date of termination of authorization”).