Cummings Property Management, Inc.

ACH Form

Please complete the following fields and then select Submit. In order to sign up for this service, your account balance must already be current. Be sure to confirm your account and routing numbers for accuracy. Your requested information will be sent the accounting department for processing. In order to start the automatic payments, requests must be submitted by the end of the current month to start withdrawals in the following month.

Be sure to fill out all required* information fields and check for accuracy of account numbers.

First Name(s)

Last Name(s)

Association Name

Community you live in

Street#

1234

Street Name

Elm Street

City, State, Zip

Flint, MI 48507

Phone

E-mail

Financial Instituion

E.G. Name of Bank

Financial Routing Number

Must be 9 digits, normally precedes your account number at the bottom of your check

Account Number

Please check for accuracy

Please indicate what type of account your assessments will be withdrawn from		*
	Checking Account Savings Account Other

Select one

Month to begin withdrawal

By submitting this request you are authorizing Cummings Property Management and Community Association Bank to initiate entries from an account of your desigination. This authority will remain in effect until you notify Cummings Property Management, in writing, to cancel it in such time as to afford the financial institution reasonable opportunity to act upon the request. This authorization will mean that if your normal assessment increases from year-to-year, Cummings Property Management will not have to be authorized again to maintain your payments. PLEASE NOTE: Additional assessments distributed with the normal payments will also be withdrawn from your account during the month that the additional assessment is due. Withdrawals are expected to be from the 3rd to the 10th each month.

Submit

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