Autopay Authorization Form - Slaton Financial Services

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Name(Required)

First Last

Name of your Association(Required)

Customer Number(Required)

Property Address(Required)

Street Address Building and/or Unit Number City State ZIP Code

Date you authorized Autopay to begin(Required)

Selecting today is the normal answer

Enter Bank ACH Information

Bank Information(Required)

Bank Name Bank Address Bank City Bank State Bank Zip

Bank Routing Number(Required)

9 Digit Number

Bank Account Number(Required)

Is this a Checking or Savings Account?(Required)

Checking

Savings

Please choose one

Autopay: Amount to process(Required)

Autopay: Amount to process

Process my current assessment, plus extra to get my account current.

(if the assessment is increased in the future the autopay amount will increase with it)

What amount over your assessment do you want Autopay to be set to?(Required)

Your Current Assessment + The amount over = put this answer in the field

Upload Proof From Bank (only 1 file needed)(Required)

Max. file size: 25 MB.

Types of proof that is needed: 1) Voided check. 2) Letter from bank. 3) Screenshot from bank app 4) Bank statement **a page that has your routing and account number** (Please redact your bank balance. We do not need to see that. If you do not give a voided check, know that we need the information that is on check. The bank name, your name and address, routing and account number)