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 II

COMPANY ID NUMBER: 54-1182440

I (We) hereby authorize WINDGATE II 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