Payment Authorization | reQuest Capital

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ACH/Credit Card Payment Form

The pre-inspection fee must be paid prior to the inspection. Payment may be made by ACH or Credit Card.

Monthly interest or rent payments associated with the loan, as well as any loan maintenance costs, may be made by ACH or Credit Card.

If payments are made by automatic draft, the loan processing fee paid at closing will be reduced from $750 to $300.

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Required fields are marked with an asterisk (*).

Choose a payment method:

1. ACH Authorization

Date

Property Address

Name on Bank Account

Bank Name

ABA Routing Number *

Bank Account Number *

* These numbers look like this:

Billing Address

City

State

Zip Code

E-mail Address

Phone #

2. Credit Card Payment Authorization

Date

Property Address

Name on Card

Card Type

Card Number

Security Code

Expiration Date

Billing Address

City

State

Zip Code

E-mail Address

Phone #

3. More Options Pre-Inspection Fee
I (we) hereby authorize reQuest Capital to process my account/credit card for a pre-inspection fee.

Pre-Inspection Fee (mailed)
I (we) will be mailing or delivering the pre-inspection fee to reQuest Capital. I (we) understand that this loan will not be processed until funds are received by reQuest Capital. (In this case, no payment information needs to be entered above.)

Monthly Interest Payments
I (we) hereby authorize reQuest Capital to automatically process my monthly interest payments on the 20th day of each month until this authorization is cancelled by phone, fax, or in writing to reQuest Capital. If I discontinue this service, I understand that a fee of $450.00 will be assessed from my account.

I (we) hereby authorize reQuest Capital to initiate entries to my (our) accounts at the financial/credit card institution and, if necessary,
initiate adjustments for any transactions credited or debited in error.

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