Intempus Property Management
20640 3 rd St. Ste 300
Saratoga, CA, 95070
P: 408-320-5509
Recurring Payment Authorization Form
THIS FORM MUST BE SUBMITTED BY THE 5 TH OF THE MONTH TO TAKE EFFECT THE
SAME MONTH IT IS RECEIVED. Ex. Turn it in by January 5 th for your January Assessment to be Automatically pulled.
I hereby authorize __________ to initiate debit entries to my account in the
financial institution named below and to debit the same in an amount equal to my monthly
assessments (as may be determined by my association). I will pay by separate check any one-
time or irregular charges, as they will not be auto-debited. This authorization does not require
the association to initiate such debits, and I expressly acknowledge that I am responsible for my
payments regardless of whether the association exercises its authority to debit such account
regardless of whether there are sufficient funds on deposit in such account. My personal
account will be charged between the fifth and the fifteenth of the month. THE FIRST
STATEMENT AFTER AUTO PAYMENT IS INITIATED MAY NOT REFLECT THE PAYMENT.
ALL STATEMENTS ARE SENT AS A COURTESY. I expressly agree that the association’s
liability under this authorization agreement shall be limited exclusively to amounts which are
negligently or intentionally debited by the association, and which exceed my assessment.
THIS AUTHORITY IS TO REMAIN IN EFFECT UNTIL THE ASSOCIATION HAS RECEIVED
WRITTEN NOTIFICATION FROM ME OF ITS TERMINATION. THE TERMINATION NOTICE
MUST BE RECEIVED IN OUR OFFICE BY THE 10TH OF THE MONTH FOR IT TO TAKE EFFECT BY THE 1ST OF THE FOLLOWING MONTH.
Please complete the information below:
