Rules for the Direct
Debit Program
By signing this form, you are agreeing to the
rules of this program.
1.
You MUST continue to mail in your payments until you receive a
confirmation letter letting you know you have been set up on the program.
Audits are performed each month to refund overpayments for mail delay of
confirmation letters.
2.
Forms must be received by the 10th of each month
in order to be processed for the following months debit. (Accounts must
have a zero balance at that time.)
3.
Your account can not be set up on the Direct Debit program unless you have a zero
balance on your account.
4.
You must attach a voided check from a checking account
in order to be able to participate in the program.
5.
Faxed forms are not accepted. We must receive the original
in order to be able to begin the process of setting you up in the
program.
6.
Your account must maintain a zero balance.
If you have a balance (due to late fees or NSF debits) on your account for more
than 30 days you will a.) Be sent a 30-day demand letter b.) Be taken off the
program at the 30th day if the balance is not paid.
7. No more than 2 NSF's a year will be allowed
in order to stay on the program.
8. KPA must be notified in writing 5
business days prior to the end of the month to discontinue the debit to your
account.
** If
not notified in writing and a stop payment occurs, you will be responsible for
the NSF fee.** The
fax number is (703)532-5098.
9. If you would like to change the
authorized Bank Account on file, you will need to fill out a new form and go
through the process as though you were a first time participant. It may take up
to 4 weeks to process the new account information.
10.
KPA will only deduct the amount of your Homeowners Association Assessment. If
you would like additional amounts to be debited from your account, you must
notify us in writing.
AUTHORIZATION AGREEMENT
FOR PREAUTHORIZED PAYMENTS
COMPANY
NAME : WINDGATE III
COMPANY ID NUMBER: 54-1212003
I (We) hereby authorize WINDGATE III hereinafter
called COMPANY, to initiate debit entries to my (our) checking account indicated
below, and bank depository named below, hereinafter called DEPOSITORY, to debit
the same to such account.
(1) DEPOSITORY NAME________________________BRANCH___________________CITY____________________
(2) TRANSIT/ABA #____________________________________
(3) ACCT. # _________________________________ (Contact
your bank for this number)
This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY a reasonable opportunity to act upon the request. I further understand that payments will be deducted on the first of the month in which the assessment is due.
NAME (S)___________________________________________________________________________________________
ON-SITE ADDRESS (ES)____________________________________________________________________________
MAILING ADDRESS_________________________________________________________________________________
See Back of form for rules before signing this
agreement.
DATE___________________________ SIGNATURE_______________________________________________________
DATE___________________________ SIGNATURE_______________________________________________________
* * * * * * PLEASE
ATTACH A VOIDED CHECK * * * * * *
**Deduction begins the first of the month
about four (4) weeks from receipt of this authorization. You will receive a
confirmation letter the week prior to the effective date.
**Continue to mail in your payments until you
receive the letter of confirmation.
**Any items not completed may result in the
return of your request.
**You may call (703) 532-5005, Ext. 45 with
any questions.
**Please fill in your current phone numbers:
Office:_______________________________________
Home:________________________________________________
**Return to: KPA,
Inc. – Automatic Debit Department
6400 Arlington
Boulevard, Suite 700
Falls Church, Virginia
22042