PAYMENT AUTHORIZATION FORM

DATE: ___/____/200_

I authorize A&J Property Management or A1 Property Maintenance to pay me electronically to my

Bank account below.

Name on account_____________________________

Name of Bank_______________________________

Phone # of Bank ( ) _______________________

Address of Bank _____________________________

Account # (normally 10 digits) ________________________

ABA/Routing # (normally 9 digits) ____________________

My email address_____________________________

I will receive an email from A&J accounting staff to let me know when the payment was sent.

I understand I will not be charged for this service. I will make any changes in writing at least 5 days before

payment is due.

MY SIGNATURE_______________________________________

MY FULL NAME_______________________________________

Please fax this form to (619) 330 2111 and email ach@ajprop.com when done to request email confirmation of receipt .You can also call (619) 819 6167.