This rental payment program deducts your rent from your checking or savings account automatically each month for the duration of your lease agreement. The withdrawal will appear each month on your bank statement and will be deducted on the first business day of each month*. To participate in automatic rent payment, simply fill in the below form and click submit.
I hereby authorize Hauenstein Agency, Inc. to initiate debit entries to my account indicated below, and the financial institution name below to debit the same to such account. Each such debit shall be made monthly, on the first day of the month in the amount listed below. I agree that each charge to my account shall be the same as if I had signed a check to pay my bill, and is subject to a $45.00 non-sufficient funds fee should the payment be unable to process for any reason. This authority is to remain in force and effect until the date listed below or until I notify Hauenstein Agency, Inc. in writing. All changes, additions to, and/or removal from the automatic rental payment program must be made in writing and received in the rental office at least 15 days prior to taking effect. This is to afford Hauenstein Agency, Inc. and the bank a reasonable opportunity to act on the addition, change, or cancellation of the automatic payment.
First Payment Date
Bank Routing Number
Bank Account Number
Account Type CheckingSavings
By clicking this box, you are digitally signing your name to this authorization form.