I (we) hereby authorize CCMC hereinafter called Company, to initiate debit entries to my (our) Bank account indicated below at the depository named below, hereinafter called Depository, to debit the same to such account.
CCMC as agent of the Association8360 E Via de Ventura, Ste 100 Bldg LScottsdale, Arizona 85258-3172(866) 244-2262
The authorization is to remain in full force and effect until COMPANY has received written notification from me (us) of its termination in such time and such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Please attach a voided check (Not deposit ticket) & return this form to:
CCMC 8360 E Via de VenturaSte 100, Bldg LScottsdale, Arizona 85258-3172
Note: All written debit authorizations MUST provide that the receiver may revoke the authorization only by notifying the originator in the manner specified in the authorization.
FOREIGN BANK ACCOUNTS ARE NOT ELIGIBLE FOR THIS PROGRAM.
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