Closing Docs

email address

phone

address

68 Sagamore St, Manchester, NH 03104, USA

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Entity or Personal Name (Please indicate who or what entity will appear on the ownership title).

Insurance Info

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EIN or Social Security Number

Your Personal Name (Please indicate your personal name, even if ownership will be under an entity).

Entity Address

Address Line 1

Address Line 2

City

State

Zip Code

ACH Form

CONSUMER AUTHORIZATION FOR DIRECT PAYMENT VIA ACH (ACH DEBITS)

Direct Payment via ACH is the transfer of funds from a consumer account for the purpose of making a payment.

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I (we) authorize Cornerstone Commercial Capital Inc. ("COMPANY") to electronically debit my (our) account and, if necessary, electronically credit my (our) account to correct erroneous debits as follows:

Checking Account
Savings Account

At the depository financial institution named below ("Depository"). I (we) agree that ACH transactions I (we) authorize comply with all applicable law.

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Depository Name

Routing Number

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Account Number

Amount of Debit

Date and Frequency: Note that all payments are due on the first day of the month. Payments via ACH should be dated on the first day of the month for each monthly payment.

I (we) understand that this authorization will remain in full force and effect until I (we) notify Cornerstone Commercial Capital Inc. by electronic mail at [email protected] to revoke this authorization. I (we) understand that Cornerstone Commercial Capital Inc. will have at least seven (7) days' notice in order to cancel this authorization.

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Name

Date / Time

Date

Time

Signature

Clear Signature

Closing Docs

email address

[email protected]

phone

603-722-1506

address

68 Sagamore St, Manchester, NH 03104, USA

ACH Form

CONSUMER AUTHORIZATION FOR DIRECT PAYMENT VIA ACH (ACH DEBITS)

Direct Payment via ACH is the transfer of funds from a consumer account for the purpose of making a payment.

Date and Frequency: Note that all payments are due on the first day of the month. Payments via ACH should be dated on the first day of the month for each monthly payment.

[email protected]

603-722-1506

68 Sagamore St, Manchester, NH 03104, USA

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