Heloc Automatic Payment (Ach) Authorization Form printable pdf download

HELOC Automatic Payment (ACH) Authorization Form

To take advantage of this FREE service, simply complete and sign this form and mail to the address at the bottom of the

form. If you choose to have your automatic payments debited from a U.S. financial institution other than RBC Bank, please

submit a voided check with your completed form. Your voided check must be from a U.S. financial institution and must be

printed with your name, address, and check number. You must continue to make your scheduled monthly payments

by check until you receive confirmation that your payments will be made automatically. It may take up to 60 days

before your account is set up for automatic ACH payments.

Borrower Information

Name: _________________________________________________ Loan Number: ____________________________

Address: ________________________________________________________________________________________

City: __________________________________________ State: __________________________ Zip: ______________

U.S. Financial Institution Information

Note: Your automatic payment may only be debited in U.S. Dollars from a U.S. financial institution

Name: __________________________________________________________________________________________

City: __________________________________________ State: _________________________ Zip: ______________

Institution Routing Number:

(always 9 digits)

If paying from your RBC Bank (U.S.) account, the Institution Routing Number is 063216608.

Account Number:

Account Type:

Checking

Savings

These numbers are located on the bottom of your check as follows:

_________________________________

________________________________

Institution Routing Number

Account Number

OPTIONAL: In addition to my/our regular payment, please deduct an additional $__________________ each month and

apply to principal.

I/We hereby authorize my/our lender to initiate a debit from my checking/savings account noted above for my/our recurring

scheduled loan payment. If the required payment changes for any reason, this authorization will be automatically amended

to authorize the debit of an amount equal to the new required payment plus any optional additional principal indicated

below. You will be notified of the month in which the first transfer will occur via mail, and this notification will serve as a

substitute of the photocopy of your authorization form.

The authorization to initiate a debit from your account will remain in full force and effect until my/our lender receives written

notice from you of its termination at least 15 days prior to the next scheduled draft date, or in such a manner and time

frame as to afford my/our lender and its correspondent bank a reasonable opportunity to act upon it. Termination requests

must be mailed to the address at the bottom of this form.

___

Account Holder Signature: _______________

___________________________________ Date: _________________

Joint Account Holder Signature: _________________________________________________ Date: _________________

Mailing Address: RBC Bank Consumer Loan Servicing, P.O. Box 90248, Raleigh, NC 27675-0248

Questions about your ACH enrollment?

Call our Real Estate Lending team toll-free at 1-866-283-5928 and select option #3.

Heloc Automatic Payment (Ach) Authorization Form

Related Articles

Related forms

Related Categories