This authorizes a one-time charge to your checking account.

**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. (Additionally if your check or ACH is returned, a processing fee will be charged.)

Checking Account 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:
* Name as it appears on check:
* Payment Amount:	US $
*  Checking Acct #:
* Bank Name:
*  Routing #:
PLEASE NOTE: 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 checking account will be processed for the amount indicated above. Payment collected 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.
I hereby authorize Mills Fuel Service to initiate ACH entries to my checking account at the financial institution indicated above. I acknowledge that the origination of the ACH transaction to my account must comply with the provision of US law.
[ fields marked as (*) are required ] If you experience any difficulties submitting your request, please contact a representative of Community Association Banc at millsfuel.com