Pay with ACH from my Checking Account – Sierra Pacific Services

Primary Buyer Information (required)

Property ID (Preferred) or APN*

Name*

Mailing Address*

Email Address*

Primary Telephone Number*

Primary Bank Account Information (required)

Name on Account*

Bank Name*

Account Number*

Routing Number*

Credit Card / Debit Card Information (optional)

If you would like to add a Credit Card to your file to avoid any late fees incase your ACH payment does not go through, please fill out the fields below. This section is optional and your card will only be charged in the event your ACH is denied.

Name on Card

Card Number

CVC Code

Expiration Date: 12/18

Consent*

If you are a Terms Buyer, you hereby agree to the following terms and conditions:*

If you are participating as a Buyer, you are required to complete this written ACH authorization. The original is retained by VR Holdings, LLC and/or its Affiliates and may be uploaded to your client contract file. Periodically, Federal and State Bank Regulators and Fraud Investigators ask for Client authorizations; if they do this authorization will be provided.

As the Buyer, you authorize regularly scheduled payments from your checking account, savings account, or debit/credit card. You will be charged at each billing cycle the total amount then due. A notification of payment will be emailed to you and shown on your statement.

I, as the buyer, authorize VR Holdings, LLC and/or its Affiliates (“VR Holdings”) to set up my promissory note using an online software application selected by VR Holdings.

I am authorizing VR Holdings to make withdrawals from one or several designated checking/savings account(s) or my debit/credit card that I have provided to VR Holdings.

I understand that my account(s) may be drafted automatically. I agree to have sufficient funds in my account and will pay all fees if my payment is dishonored by my bank or credit union for any reason.

I as the buyer authorize VR Holdings, LLC and/or its Affiliates to initiate instructions for funds to be charged/debited from my checking account, savings account, or debit/credit card on the same day each month based on the day your down payment was made for payment of all obligations under my promissory note . I understand that a charge from the Beneficiary may appear on the account noted above and that I have access to my payment records. I understand that VR Holdings is using automated accounting and payments.

I have verified with my Financial Institution that the account indicated below can receive an ACH Debit item. Furthermore, I assert that I am the owner or an authorized signer of this bank account.

This authority is to remain in full force and effect until VR Holdings has received notification from me of its termination in such time and in such manner as to afford VR Holdings and the Financial Institution a reasonable opportunity to act upon it.

I understand that I have complete access to my Land Contract and payment records and I will receive e-mail alerts to the e-mail account associated with my note.

I agree to notify VR Holdings in writing of any changes in my account information or termination of this authorization 15 days prior to the next due date of the charges.

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

I understand that if there is not money in my account that I may be charged added fees by my bank and by VR Holdings. I will not dispute the VR Holdings recurring billing with my bank; so long as the transaction corresponds to the terms indicated in this agreement or as modified by the parties.

If my ACH transaction does not go through, or if ACH / Bank Account information is not entered above, I authorize VR Holdings to charge my credit or debit card for the monthly amount.

By submitting your Digital Signature below, you are agreeing to the terms and conditions described above.

Signature*

Comments

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