autopayment This form should be used by HMAS members who want to set up recurring payments for their dues. HMAS will automatically charge your card and give you a receipt. Please enable JavaScript in your browser to complete this form.Personal InformationLayoutMembers Full Name *Phone Number *LayoutBank Name *Routing number *Example 051000017: 004128123456:_____________________ 051000017 is routing numberAccount number *Example 051000017: 004128123456: _____________________004128123456 is account numberName as shown on the Account *Terms and ConditionsCheckboxes *I give HMAS permission to automatically charge my bank account on file for all contribution bills.Checkboxes (copy)I agree to receive email and text messages for the receipt.Applicant's Signature *Clear SignatureDate *Submit
