New Servicing Account Requirements and Forms 8.1.2016

3636 N. Central Ave. Phoenix, AZ 85012 Phone: (602) 266-0642 Fax: (602) 230-6268

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

Savings

o

o

To prevent delay of your deposit, please contact your bank for correct deposit instructions.

Special Instructions (if any) _______________________________________________________

PAYEE:

_______________________________________

______________________________________

Phone No.: _____________________________

Email: _________________________________

Asdefta