ACH Payment Authorization Form

Please complete this form to authorize ACH payments from your bank account. 

NOTE: ACH payments are pulled on the 5th day of each month (or the following business day if the 5th falls on a weekend or holiday).


By completing and submitting this form, I hereby authorize the Redmond Ridge ROA to initiate ACH debits to the bank account I have provided for the total amount due on my Redmond Ridge ROA account. 

I understand that this authorization is voluntary and may be revoked at any time by providing written notice at least 10 days prior to the scheduled ACH debit. This authorization is to remain in effect until written notice of termination. 

I further understand that if my ACH payment is returned for any reason, I will be charged a Returned Item Fee of $30.

List your name as shown on your bank account.

List the address of your home in Redmond Ridge