One-time ACH Payment Form This one-time ACH payment can be used for any outstanding balance which is due on your account. Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Enter Email Confirm Email Date for ACH Withdraw(Required)The debit will occur on this date. MM slash DD slash YYYY Total amount to withdraw(Required)Enter total amount to debit from your account.Type of Bank Account(Required)Checking AccountSavings AccountBank Routing Number(Required)Enter only your banking routing number. This can be found on your personal check. Bank Account Number(Required)Enter only your banking account number. This can be found on your personal check. Consent to authorized a one-time ACH payment to Lido Isles HOA, Inc.(Required) I hereby authorize Lido Isles HOA to initialize a withdrawal in the total amount listed on this form from the above listed account in which I am an authorized user on this financial account. This total amount will be debited on the date listed and that posting will show on your bank statement as Lido Isles HOA ACH Payment from Popular Bank. If the payment is returned for NSF or any other reason, the amount retuned will be applied back to your account with an additional processing fee.ConfirmationThank you for your prompt payment. You will receive an email confirmation after the payment is processed. Δ One-time ACH Payment Form This one-time ACH payment can be used for any outstanding balance which is due on your account. Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Enter Email Confirm Email Date for ACH Withdraw(Required)The debit will occur on this date. MM slash DD slash YYYY Total amount to withdraw(Required)Enter total amount to debit from your account.Type of Bank Account(Required)Checking AccountSavings AccountBank Routing Number(Required)Enter only your banking routing number. This can be found on your personal check. Bank Account Number(Required)Enter only your banking account number. This can be found on your personal check. Consent to authorized a one-time ACH payment to Lido Isles HOA, Inc.(Required) I hereby authorize Lido Isles HOA to initialize a withdrawal in the total amount listed on this form from the above listed account in which I am an authorized user on this financial account. This total amount will be debited on the date listed and that posting will show on your bank statement as Lido Isles HOA ACH Payment from Popular Bank. If the payment is returned for NSF or any other reason, the amount retuned will be applied back to your account with an additional processing fee.ConfirmationThank you for your prompt payment. You will receive an email confirmation after the payment is processed. Δ