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100% FREE THERE IS NO CHARGE FOR THIS SERVICE ACH DEBIT AUTHORIZATION FORM – Trike Property Management Resident Authorization for Recurring Direct Debit 1. Complete the Resident Address Section. Property Manager Name 2. Complete the Bank account Information. 3. Read and Sign the Authorization portion. 4. Retain a copy of this form for your records. 5. Fax or mail the original along with a copy of a voided check from the account the debit will be made. Fax Number: 414-332-5511 Resident Information Trike Property Management Information Name:____________________________________ Trike Property Management Address:__________________________________ P.O. Box 11159 Apt No.:__________________________________ Milwaukee, WI 53211 City:_____________________________________ Phone: 414-332-5500 Fax: 414-332-5511 State:_____________________________________ email@example.com Zip:______________________________________ www.trikepm.com Phone:____________________________________ E-Mail:___________________________________ Bank Account Information I would like the monthly rental amount to be debited from the following account: Account Type: Checking Savings Debit Bank Name: Account Holder’s Name: Account Number: Routing Number: Recurring Debit Start Date: Month:____________________ Day: 1st 2nd 3rd Note: Please attach a voided check and Circle One return with this form. $ Signature:__________________________ Rent Amount: Credits to be applied to 1st payment if any: Date:______________________________ $ Authorization I (we, if joint account) hereby authorize Trike Property Management (processor) to initiate credit/debit entries to my (our) Checking or Savings account at the financial institution as indicated above. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of the United State law. If I (we) do not have enough money in my (our) funding account to cover the transfer or if my (our) Financial Institution for any other reason refuses to honor a transfer, I (we) will separately pay Trike Property Management for the charges I (we) owe under this service contract. FEE NOTICE: I (we) acknowledge and agree to a service charge that will be added to each transaction. Furthermore, I (we) acknowledge and agree to a $ 30.00 Non Sufficient Fund charge, should there not be enough money in the funding account and the ACH charge is declined and / or returned. This authorization is for the recurring monthly debit of the rental amount and service charge as indicated above, and is to remain in full force and effective until we have received written notification from you (or us) of its termination in such time and in such manner as to afford the Financial Institution and us a reasonable opportunity to act on it. We deem this to be seven (7) days. You may cancel this agreement at any time by faxing (414-332-5511) or mailing a written request to our leasing office. Trike Property Management reserves the right to cancel this agreement at any time.
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