¨ I have read and agree to the terms and conditions regarding the electronic Funds Transfer (EFT) Payment Program. I hereby authorize Foxmoor to receive payment of my rent/dues by initiating EFT entries to my:
Please Check One	¨Checking			¨Savings
At the financial institution listed below. This authority will remain in effect until I have cancelled it in writing. Contact your bank for routing numbers required below.
Your Account Number		Daytime Telephone
Bank Name and Branch
Bank Routing Number			Bank Account #
Name(s) on Bank Account
Social Security Number
Name(s) on Bank Account
Social Security Number
Signature as it appears on your Bank Account					Date

Electronic Funds Transfer Terms & Conditions

(Please save a copy for your records)

Eligibility

All existing Foxmoor Owners with satisfactory payment history and all new Foxmoor Owners are eligible for the Electronic Funds Transfer (EFT) Payment Program. There is no charge to the Owner for this service. To sign up for the EFT Payment Program, complete the adjacent form, attach a voided check, and return them to Foxmoor in person, by mail or by fax to (352) 331-7190. If you are authorizing payment from a savings account, a voided check does not have to be attached, but you must contact your bank for the bank routing numbers and account number to be filled in on the authorization form. Processing between us, our bank, and your bank may take 30 to 60 days. Foxmoor will send you written notices stating when your EFT payments will begin. Please continue to pay your Foxmoor Homeowners Association dues as usual until you receive the written notice. You will not be placed on the EFT payment program unless your Foxmoor Home Owners Association dues are paid in full.

Billing

The EFT payment will be deducted from your bank account on the first Friday of each month.

Billing Disputes

You will still be able to question your bill. To do so, simply call or write Foxmoor of any billing dispute within 10 days of the bill date.

Insufficient Funds (NSF)

If your bank for any reason does not honor your EFT payment, Foxmoor will notify you of such in writing, and you must pay your account in full before your next bill. A NSF fee will be added to your bill for each occurrence of a non-paid EFT transaction. If your next bill contains past due balance, you will be removed from the EFT Payment Program until such time as your account is paid in full. The privilege of payment through the EFT payment Program may be reinstated at the Owner’s request subject to approval.

Changes or Termination

EFT Payments will be drawn upon the bank account authorized at the time of billing for withdrawal. You are responsible for notifying Foxmoor in writing when you change or close the authorized bank account.

You may discontinue making payments through the EFT Payment Program at any time with written notice to Foxmoor.

Written requests may be brought to the Foxmoor office at 10404 SW 24^th Ave, or mailed to Foxmoor Homeowners Association c/o MaCor Realty, Inc. at Post Office Box 140502, Gainesville, FL 32614.