Select One:     ADDITION         CHANGE            DELETION TO USE THIS FORM YOU MUST PRINI IT.  A window opens to allow you to directly type your response to questions listed below.  After you complete your responses, print the form directly from your browser's print option---and mail together with a voided check to CFM Management Services, 5250 Cherokee Avenue, Suite 100, Alexandria, VA 22312-2063 or ---you may send it to CFM via your Association’s Property Manager. COMMUNITY          NAME                                     UNIT NUMBER        ST. ADDRESS         CITY/STATE/ZIP      Until further written notice, by my/our signature(s) below, I/We authorize CFM Management Services to charge my/our: Checking Account           Savings Account I/We understand that the above checked account will be charged on the first day of each month for my/our association fee payment.  I/We understand that I/We should continue to remit payments until I/We receive written confirmation that automatic payments will begin.  This authorization will remain in effect until revoked by me/us in writing. DEPOSITORY (BANK) NAME      ABA ROUTING NUMBER             My/Our ACCOUNT #                     STOP AND PRINT FORM NOW USING YOUR BROWSER'S PRINT OPTION.  This form cannot be accepted without written signature.  After signing, mail to CFM as noted above. I (we) attest that I (we) have read and understand the procedures listed on the this form and I (we) accept the responsibilities involved as a participant for direct debit of condominium preauthorized payment. DATE                         SIGNATURE             SIGNATURE             (if joint account) DAYTIME PHONE                                                      DON’T FORGET TO AFFIX A VOIDED CHECK TO THIS FORM