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Electronic Funds Transfer Authorization Form

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Electronic Funds Transfer (EFT) Authorization Form for Landlords

COMPANY NAME ID: SILVER STATE REALTY & INVESTMENTS

COMPANY TAX ID NUMBER: 71-0878495

I (we) hereby authorize Silver State Realty & Investments, hereinafter called COMPANY, to initiate EFT credit

entries, and to initiate, if necessary, debit entries and adjustments for any EFT credit entries in error, to my

(our) ___ checking ____ savings account (select one) indicated below, hereinafter called DEPOSITORY, per

terms of my (our) Exclusive Rental Management Agreement.

DEPOSITORY NAME: __________________________________

BRANCH:__________________________

CITY: _____________________________ STATE: __________

ZIP: _________________________

TRANSIT/ABA NO: ______________________________________________________________________

ACCOUNT NO: _________________________________________________________________________

LANDLORD’S TAX ID NUMBER: ____________________________________________________________

DRIVER’S LICENSE NUMBER: ___________________________________ STATE: __________________

This authority is to remain in full force and effect until COMPANY has received written notification from me (or

either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a

reasonable opportunity to act on it. I (we) also hereby warrant to COMPANY that I (we) have full elgal

authority to authorize EFT transactions to the account listed above and I (we) acknowledge that the

origination of EFT transactions to my (our) DEPOSITORY must comply with the provisions of U.S. law governing

such transactions.

NAME(S): ______________________________________________________________________________

(Please Print)

DATE: ______________ SIGNED: __________________________________________________________

Please write “VOID” across one of your checks and return to us with this Authorization Agreement.

In order for your funds to be directly deposited to your account, this form must be received by our office no

later than two weeks prior to your first electronic funds transfer. No exceptions.

Voice: (702) 730-2080  Fax: (702) 947-6111 

 Email:

9325 W. Sahara Ave.  Las Vegas, NV 89117

Electronic Funds Transfer Authorization Form

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