ACH form

Shopping Center*

Tenant Name(s)*

I (we) hereby authorize BC Wood Properties, LLC and it’s wholly owned subsidiary properties hereinafter called LANDLORD, to initiate debit entries to my (our) checking account indicated below and the Depository named below, hereinafter called DEPOSITORY, to debit the same to such account.

Account Holder's Name*

Depository (Bank) Name*

Depository (Bank) Address*

City

State

ZIP Code

Account Holders Tax ID #*

Routing/ABA Number*

Account Number*

This authority is to remain in full force and effect until LANDLORD and DEPOSITORY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the LANDLORD and DEPOSITORY a reasonable opportunity to act on it.

Tenant's Names(s)*

Signature*

[clear]

Use your mouse or finger to draw your signature above

Date/Time*

Tenant email for notification of ACH*

If you have questions please contact our office.

Attach a Voided Check*

No File Chosen

File uploads may not work on some mobile devices.

Your information will not be shared with anyone and will only be used for ACH debits for your agreed upon rent amount by BC Wood Properties