HOA DUES PAYMENT

Authorization Agreement for Credit Card Payment

This authorizes a one-time charge to your credit card.

**Please make sure all fields are complete. Incorrect information may cause a delay in processing.

**PLEASE NOTE: Once all information has been submitted, you will receive an email confirming we have received your request. A second email will be sent indicating successful completion of your payment along with a confirmation number for your records.


We accept the following credit cards:

(Due to Visa regulations, effective 03/30/2007 at 12:00 PM MST,
CABanc will no longer be accepting Visa Credit Cards as a method of payment)



YOU WILL BE CHARGED A CONVENIENCE FEE FOR THIS TRANSACTION

Credit Card Billing Information
* First Name:
* Last Name:
* Address:
* City:
* State/Province:
* Zip:
* Phone #:	()   -
* Email:
Property Address (if different from billing address) (Property Address Is Not Needed For Timeshare Owners)
Address:
City:
State:
Zip:
Payment Amount Fee 0 – $150.00 $5.00 150.01 – 300.00 $10.00 300.01 – 500.00 $15.00 Greater than $500.01 $25.00
* Mgmt Co. ID
* Assoc. ID
* Association Name:
* Mgmt Company:
* Assoc. Account #:
* Name as it appears on credit card:
* Payment Amount:	US $  Can not exceed $9,999.99
* Card Type:	MasterCard American Express Discover
* Card Number:
* Card Expiration Date:	2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 / 1 2 3 4 5 6 7 8 9 10 11 12
**Please use billing address for the credit card. **A convenience fee is charged for credit card payment requests. Payments could take up to 5 days to be posted to your account. In order to avoid late charges by your Association, payment should be submitted 5 days prior to your due date. Authorized charges to your credit card account will be processed for the amount indicated above (including convenience fees). Payment collected (excluding convenience fees) will be deposited to the checking account of your ASSOCIATION, maintained with the BANK, and will be reported to the ASSOCIATION, its managing agent or designated representative in a timely manner. Convenience Fee Amounts are based on the base payment amount.
Payment Amount Fee 0 – $150.00 $5.00 150.01 – 300.00 $10.00 300.01 – 500.00 $15.00 Greater than $500.01 $25.00
[ fields marked as (*) are required ] If you experience any difficulties submitting your request, please contact a representative of Community Association Banc at HOA@CABanc.com