ACH Authorization Form

THIS AUTHORIZATION IS TO REMAIN IN FULL FORCE AND EFFECT UNTIL THE TOWNSHIP OF MEDFORD HAS RECEIVED WRITTEN NOTIFICATION FROM ME (US) OF ITS TERMINATION.  IN SUCH TIME AND IN SUCH MANNER AS TO AFFORD THE TOWNSHIP OF MEDFORD A REASONABLE OPPORTUNITY TO ACT ON IT.  I (WE) UNDERSTAND THAT MY (OUR) BANK ACCOUNT WILL BE DEBITED ON THE STATUTORY DUE DATE FOR PROPERTY TAXES (FEBRUARY 1, MAY 1, AUGUST 1, NOVEMBER 1) AND ON THE 15^TH OF THE MONTH OF WHICH UTILITIES ARE DUE (JANUARY 15, APRIL 15, JULY 15, OCTOBER 15). 

BY SIGNING THIS AUTHORIZATION, YOU ARE RESPONISBLE FOR NOTIFYING THE TAX COLLECTOR’S OFFICE OF ANY CHANGES IN ACCOUNT INFORMATION, ETC.  SHOULD YOU SELL YOUR PROPERTY, PRIOR TO SETTLEMENT THE TAX COLLECTOR’S OFFICE MUST BE NOTIFIED IN WRITING TO REMOVE THE AUTOMATED CLEARING HOUSE (ACH) BANKING INFORMATION FROM YOUR ACCOUNT(S).