VIHFA Direct Debit Authorization Agreement Form
VIRGIN ISLANDS HOUSING FINANCE AUTHORITY 3202 Demarara No. 3+ Frenchtown Plaza + Suite 200 + St. Thomas, USVI 00802 Telephone (340) 777-4432 + Fax: (340) 775-7913 Email: vihfa@vihfa.gov DIRECT DEBIT AUTHORIZATION AGREEMENT (PLEASE PRINT OR TYPE INFORMATION) NAME: LOAN NUMBER: I/WE hereby authorize the VIRGIN ISLANDS HOUSING FINANCE AUTHORITY, hereinafter called the AUTHORITY, to initiate debit entries from my/our deposit account at the financial institution identified below and apply the same amount as a credit to my/our account listed above for the duration of the term. A fax copy of this authorization is not allowed. FINANCIAL INFORMATION: PLEASE CHOOSE ONE: CO CHECKING (attach a voided check) OC SAVINGS (Attach a statement copy) Financial Institution name Branch Tel. No. Address City State Zip Code $ Routing Number (9 digits) Bank Account No. Amount I/We acknowledge that the origination of ACH transactions to my/our account must comply with the provision of U.S. law. This authorization is to remain in full effect unless written notification to cancel is received by the AUTHORITY. …
Download the original document · Plain text (TXT) · Browse the archive · How this archive works
Original source: https://vihfa.gov/wp-content/uploads/2023/08/VIHFA_Direct_Debit_Authorization_Agreement_Form.pdf
SHA-256 fc1958056b518fbd454c589280c282846ae9d064ab5d0dd155b48a9b43f2f714
Re-using this document
An instrumentality of the Government of the Virgin Islands. No rights are stated anywhere: the document carries no copyright notice and the body publishes no terms of use. 17 U.S.C. § 105 does not reach territorial government, so nothing makes it public domain by operation of federal law — it publishes as a territorial public record, and we say plainly that the position is unstated rather than settled.
Our description, tagging, arrangement, extracted text and machine transcripts are released under CC0 1.0. We assert nothing about the document itself.
Archive identifier LF-fc1958056b51
Document text
VIRGIN ISLANDS HOUSING FINANCE AUTHORITY 3202 Demarara No. 3+ Frenchtown Plaza + Suite 200 + St. Thomas, USVI 00802 Telephone (340) 777-4432 + Fax: (340) 775-7913 Email: vihfa@vihfa.gov DIRECT DEBIT AUTHORIZATION AGREEMENT (PLEASE PRINT OR TYPE INFORMATION) NAME: LOAN NUMBER: I/WE hereby authorize the VIRGIN ISLANDS HOUSING FINANCE AUTHORITY, hereinafter called the AUTHORITY, to initiate debit entries from my/our deposit account at the financial institution identified below and apply the same amount as a credit to my/our account listed above for the duration of the term. A fax copy of this authorization is not allowed. FINANCIAL INFORMATION: PLEASE CHOOSE ONE: CO CHECKING (attach a voided check) OC SAVINGS (Attach a statement copy) Financial Institution name Branch Tel. No. Address City State Zip Code $ Routing Number (9 digits) Bank Account No. Amount I/We acknowledge that the origination of ACH transactions to my/our account must comply with the provision of U.S. law. This authorization is to remain in full effect unless written notification to cancel is received by the AUTHORITY. By signing this documentation, you are agreeing not to dispute or cancel these charges. £ Signature Date £ Signature Date St. Croix Office: Frits Lawaetz Complex: Suite 210- Frederiksted, St. Croix VI 00840 - Telephone (340) 772-4432 TERMS OF AGREEMENT Please ensure that you have read the following before signing the Direct Debit Authorization Agreement. Please retain a copy of this page for your records. e The Authority may vary this agreement at any time by giving you at least 15 days notice. e By signing a Direct Debit Authorization, you request and authorize the Authority to arrange for funds to be debited from your account as provided in this Authorization Agreement. The amounts drawn will be in accordance with your coupon or any greater amount which you, or either of you, instruct the Authority to draw. The Authority will arrange for funds to be debited from your account: e as requested and authorized in the Direct Debit Authorization Agreement; and e in accordance with this Agreement. The payment will be deducted from your nominated account on the /5t# of the month. If this date falls on a non-working day- or a federal or local holiday, the payment will be processed on the next business day. It is your responsibility to ensure that you have sufficient funds in the nominated account when payments are to be drawn. If you do not have sufficient funds, then: e the payment will be regarded as not having been made; © a processing fee will be charged to your account in the amount of $50.00 along with the late fee; e and you are required to visit the office and make the payment along with any other fees that have been accrued as a result. If you believe that there has been an error in debiting your account you should contact the Collections & Servicing Division at (340) 777-4432 or 772-4432 between the hours of 8am to 4pm, Monday to Friday so that we may resolve your query quickly. Your records and account details will be kept private and confidential and will only be disclosed at your request or the request of the financial institution in connection with a claim made to correct an alleged incorrect or wrongful debit or otherwise as required by Jaw. - I/We have read the terms of the Direct Debit Authorization Agreement. Initial(s) / Date: / /