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ACH Form

First Name

Last Name

Email Address

Phone Number

Bank Account Holder Name

Street Address on Bank Account

Apt/Unit

City

State

Zip Code

Bank Name

Routing Number

Account Number

Account Type

I hereby authorize Suburban Golf Club (SGC) to initiate debit entries to my bank account indicated above at the financial institution named above. This authorization applies to membership dues, fees, charges, assessments, or any other financial obligations associated with my membership. I understand that this authorization remains in effect for the entirety of my membership. It may only be terminated once I have fulfilled all outstanding financial obligations to SGC and formally ended my membership in accordance with SGC’s policies.

I hereby authorize Suburban Golf Club (SGC) to initiate debit entries to my bank account indicated above at the financial institution named above. This authorization applies to membership dues, fees, charges, assessments, or any other financial obligations associated with my membership. I understand that this authorization remains in effect for the entirety of my membership. It may only be terminated once I have fulfilled all outstanding financial obligations to SGC and formally ended my membership in accordance with SGC’s policies.

Please sign if you agree to all of the above

Signature