Dear Customer,


In the interest of better customer service and because we have had numerous requests, we are offering a new Automatic Payment program.  Electronic payments are becoming very popular everywhere.  We feel it will be a great no extra cost convenience to you.  Simply put, this will give your bank permission to pay our bank every month without you having to worry about writing and mailing checks or late fees every month.

Sincerely,
The Management

ELECTRONIC FUNDS TRANSFER AUTHORIZATION FORM

I hereby authorize ___________________________ to initiate automatic re-occurring payments from my bank account as specified below:

Your Name: Address: City: Your Bank's Name: Your Bank Account #: Bank Routing No. Amount Due:

______________________________ ______________________________ ______________________________ ______________________________ ______________________________ _____________________________              ( 9 CHARACTERS ) ______________________________

Please Deduct payment Amount of: $ ________ or variable monthly payments.

Period:     _____________ time(s) a month on the 1st of each month, beginning with the month of ____________, 200__.

I understand this authority is to remain in full force and effect until _______________________ has received written notification from me of its termination in such time and in such manner as to afford the depositor a reasonable opportunity to act on it.  I maintain the right to stop payment of the debit entry (deduction) by written notification delivered to _______________________ ten (10) business days or more before this payment is scheduled to be made.

Signature: ______________________________Date: _________200__

ATTACH A VOIDED CHECK BELOW:

The Automated Clearing House (ACH) division of the Federal Reserve Bank says electronic funds transfer (EFT) is by far safer and more secure than writing a check.  EFT is tracked and governed by the ACH.  It is transmitted in an encrypted format while a check passes through an average of 11 people who have access to all of your bank account and personal information.