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Headline: AUTOMATIC WITHDRAW PROGRAM

Pay your BLA bills automatically with the Automatic Withdraw program.

We now have the capability to do automatic withdraw from your checking account to make payments. If you are interested please fill out the form below and attach with a voided check. If you have any questions please contact Beaver Lake Association Office: 235-2241 our business hours are 8:00am- 4:30pm Monday-Friday.


Debit Authorization

I (we) hereby authorize Beaver Lake Assoc., hereinafter called COMPANY, to initiate debit entries to my (our) account indicated below and the financial institution named below, hereinafter called FINANCIAL INSTITUTION, to debit the same to such account for (Application). I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.

(Financial Institution Name) (Branch)

(Address) (City/State) (Zip)

______________ ______________Type of Acct:____Checking___Savings
(Routing Number) (Account 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 manner as to afford COMPANY and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

________________________ ________________________
Print individual Name) (Signature)

#_____________ ________________________
(Lot Number) (Date)

PLEASE ATTACH COPY OF VOIDED CHECK TO THIS FORM

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Date Published: 10-22-2007