CREST PREMIER PROPERTIES 4625 S. Lakeshore Dr., Suite #300, Tempe AZ, 85282 Office (480)838-9558 Fax (480)838-9507 Account Withdrawal Authorization I hereby authorize Crest Premier Properties to withdraw funds from the Banking service and account listed below. The one time only amount to be withdrawn shall be in the amount of $______________. These funds shall be applied to the Operating Account for the property Located at ___________________________________________. $3.00 charge for direct withdrawal. Banking Service: _________________________________ Routing Number: _________________________________ Accounting Number: ______________________________ Name on Account (PRINT): _________________________ Account Owner Signature: _________________________ Date: ______________________ |