Auto Debit Form for Quarterly Fees

Use this form to sign up for the automated way to make your association maintenance fee payments. Features of this system are as follows:

• Payments are automatically deducted from your designated bank account on the 3 rd day of the month or quarter in which the payment is due. If the 3rd falls on a holiday or weekend, your payment will be deducted on the next business day.

• The designated bank account can be any Federal Reserve Bank member located in the United States.

• Forms must be received by Cadence Bank by the 20th of the month prior to your first payment activation. If this cannot be performed, please use your coupon or invoice and a check for the first payment.

To sign up for this payment system, please complete this form and send the original to the bank with the following items:

• A voided check from your designated account

• The last coupon from your association coupon book (if you have been provided a coupon book). If you pay monthly, this will be your December coupon; if you pay quarterly, this will be your October coupon.

MAIL TO:

Cadence Bank

c/o Association Services Department

P.O. Box 49408, Sarasota, Florida 34230-6408

Phone: 1 (877) 329-1415 Fax: 1 (877) 238-3303