I authorize Reser Properties to initiate either an electronic debit or to create and process a demand draft against my bank account on or after (date) for the amount of $

My account information is as follows:
Bank Information:
Bank ABA Number [Routing Number]
Bank Account Number [Account Number]
Bank Account Type:
Checking
Savings
Business Checking
[Signature] By submitting this form I give my electronic signature
[Printed Name]
[Date Signed] / / .

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