Having your payment drafted to us is easy.  Simply print this page and present it upon arrival or mail it to the address below.

LOAN NUMBER ______________

Mailing address for ACH Draft Authorization:

Commonwealth Auto Credit, LLC
1073 W Mercury Blvd
Hampton VA 23666-3327

Name __________________________

Address __________________________

City, State, Zip __________________________

Your Bank Name _________________________

Bank Phone Number __________________________

Account Number __________________________

ABA Routing Number __________________________

Is this a Checking or Savings account? (Please circle one)
PLEASE ATTACH A VOIDED CHECK (for checking) OR DEPOSIT SLIP
(for savings) FROM THE ACCOUNT YOU WISH US TO USE.

Commonwealth Auto Credit, LLC will automatically draft your monthly payment on the due date of your loan. The full amount of your payment agreed in the contract will be deducted. No partial payments will be deducted. Any additional funds (over amount of payment due) will be applied to the principal of the loan. If your payment is due on the 1st of the month, we will draft your payment on the 1st. If your payment is due on the 12th of the month, we will draft your payment on the 12th.

I hereby authorize Commonwealth Auto Credit, LLC to draft my monthly payment on the above-referenced loan from the financial institution indicated above. I further authorize Commonwealth Auto Credit, LLC to attempt to draft my payment up to an additional two (2) times should the first draft be rejected by my financial institution because of insufficient funds. I understand that Commonwealth Auto Credit, LLC will draft an additional $25.00 NSF fee should my draft be returned for insufficient funds.

_______________________
Signature Authorization

______________
Date

_______________________
Daytime Phone Number

________________________
Print Name

____________________
Evening Phone Number