Authorization Agreement for Direct Payments (ACH Debits)

Company Name:
Company ID #:
Transpacific Management Service
95-2759687


I (We) hereby authorize Transpacific Management Service, hereinafter called COMPANY, to initiate debit entries to my (our) (   )Checking (   )Savings Account (select one) indicated below at the depository institution named below, hereinafter BANK, in the amount of any assessment duly authorized and noticed by my association's Board of Directors.

ATTACH VOID CHECK HERE

This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of it's termination in such manner as to afford COMPANY and BANK reasonable opportunity to act upon it.

Name(s)_________________________     __________________________
                            Please print                                       Please print

Signature(s)______________________     __________________________

Association___________________________________________________

Daytime Phone Number_________________________________________

Date___________________________

Homeowners Association Account Number__________________________
                                                                                             (From assessment statement)

**Please note** To insure accuracy, please attach a void or canceled check from the account identified above. You will receive a letter confirming the date we will begin to pay your assessments by ACH Debit prior to the first charge.

To expedite your new ACH Debit set up you may mail this application, with a void check to P. O. Box 4498, Santa Ana, CA 92702-4498 or FAX it to (714) 647-9393.