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3636 N. Central Ave.
Phoenix, AZ 85012
Phone: (602) 266-0642
Fax: (602) 230-6268
Asdefta
ELECTRONIC FUNDS TRANSFER AUTHORIZATION (
Direct Deposit
)
Date: _________________________
Escrow #: _____________________
Property Address: ________________________________________________________________
I/We hereby authorize Security Title Agency to disburse our monthly deposits under the above
referenced escrow as follows:
þ
Direct Deposit (ACH): (Bank Name)* ______________________________________________
(Your Financial Institution posting time may delay deposit into your account)
Address: ______________________________________________________________________
Phone Number: _________________________________________________________________
ABA/Routing No.: ______________________________________________________________
Account No.: ___________________________________________________________________
Name of Account: _______________________________________________________________
Checking
o
Savings
o
To prevent delay of your deposit, please contact your bank for correct deposit instructions.
Special Instructions (if any) _______________________________________________________
PAYEE:
_______________________________________
______________________________________
Phone No.: _____________________________
Email: _________________________________