Pay Via Bank Account (ACH)
New
Confirmation Number:
System
date
Transaction
Date: Payment Date:
Payment
Amount:
Account
Type:
Routing
Number:
Account
Number:
Error
Code and Message:
Error
Detail:
Submit
Payment
Cancel
Note: All fields will be pre-populated with the exception of the Routing & Account Number (highlighted in yellow). The lender will be responsible for completing those fields.
Pay Via Bank Account (ACH)
New
Lender
Name: Payment Status:
Servicer
Name: Confirmation Number:
Reporting
Period: MM /
YY
Consolidation Loans Subject to the 1.05% fee; applicable rate: 0.000875
Number
of Loans:
End-of-Month
Principal Balance:
EOM
Accrued Unpaid Interest Balance:
Consolidation Loans Subject to the 0.62% fee; applicable rate: 0.0005167
Number
of Loans:
End-of-Month
Principal Balance:
EOM
Accrued Unpaid Interest Balance:
Total
Consolidation Loan Rebate Fee
System
date
Payment
Amount:
Business
Checking
Routing
Number:
Account
Number:
Error
Code and Message:
Error Detail:
Submit
Payment
Cancel
File Type | application/msword |
File Title | ACH Remittance Form Design |
Author | vicki.tseng |
Last Modified By | Angela.Roca-Baker |
File Modified | 2007-05-15 |
File Created | 2007-05-15 |