Fillable Printable Automatic Loan Payment Authorization Form

Automatic Loan Payment Authorization Form

AUTOMATIC LOAN PAYMENT AUTHORIZATION FORM

Now There's A Better Way To Pay.

If you have a home loan, fixed rate equity loan, equity line of credit or auto loan serviced by First Federal, Automatic

Loan Payme nt is the easi est wa y to make sure your monthly payments are made on time ever y time. W ith Automatic

Loan Payment your payments are made automatically each month without having to write and mail your c heck.

Setting Up Automatic Payments is Easy:

Step 1:

Print, Complete and Sign the Authorizati on Form on the next page.

Step 2:

Drop off the form and void ed check or ticket at any First Federal banking

center location or mail to :

First Federal Bank

Attn: Collections

P.O. Box 419194

Kansas City, MO 64141-6194

AUTOMATIC LOAN PAYMENT AUTHORIZATION FORM

Month to begin Automatic Transfer

____________________________________

(Please allow 3-4 we eks for set-up and activation.)

Date to draw payment: (circle one)

Home Loan 1

*Auto Loan: circle due date 1

15th

20th

25th

*Equity Loan: circle due date 1

15th

20th

25th

*Equity Line of Credit 15th

20th

25th

*IMPORTANT NOTICE. First Federal will not draw final payment. A maturity notice will be mailed.

Regular payment amount** $______________

Additional monthly payment to principal

(Optional – not required) $______________________

**[Regular payment amount for equity line of credit loans is the amount of accrued interest. (Examples: $5,000 x 18% /12= $75;

$200,000 x 18%/12 = $3000), $50 minimum]

Transfer payment from checking or savings account #____________________________

Name of bank (bank name from which funds are to be drawn)__________________________________

Routing/ABA # of bank____________________________________________________

Address of bank__________________________________________________________

City_________________________ State_________________ Zip code _____________

Phone (_______) _________________________________________________________

Apply payment to loan # (your First Federal Bank loan number) ____________________________________________

I authorize First Federal Bank, FSB (First F ederal) to transfer/debit funds, each month, in the amount specified on this

form, and apply the funds to the loan accoun t also indicated on this form at First F ederal. I acknowledge that the

origination of ACH transactions to my account must comply with the provisions of U.S. law.

I also agree to maintain an account with a sufficient bal ance to cover these monthly payment s. As long as a sufficient

balance is maintained in the accou nt to cover any payment authorized, I understand that I will not be in default of my loan

payment. I also agree to have sufficient funds in the account at First Federal or another financial i nstitution, as specified,

at least FIVE (5) business days before the date the payment is transferred. I understand that if sufficient funds are not

available in the account at the specified time of transfer, non-sufficient fund s service fees AND late charges, if applicabl e,

will be charged to my account. I also understand that, in the event that my loan is sold or transferred by First Federal,

this agreement will end with written notice from First Federal . This Authorization is to remain in effect until revoked in

writing 3 business days prior to the draw date by either party. Adjustments in the transfer amount may occur for

adjustable loans, or during es crow analysis.

I understand that if any automatic payme nt is disho nored, with or without cause, intentionall y or inadvertently, First

Federal will be under no liability whatsoever.

Authorized by (please print your name here)_________ ____ _________ ____ _________ ____ _________ ____ _________ ____ _

Signature________________________________ Date____________________________

I acknowledge that I received a cop y of this form.

Signature________________________________ Date___________________________

To be completed by First Federal

 Final Disbursement date _____ ____________

 New Account

 Change only

Name of emp loyee processing form_______ ___________ ______ Date_______ ____________

Name of emp loyee setting up ALP ________ ________________ Date_ __________ ________

Original to Loan Servicing / Photocopy for Customer