Urban Select Realty Inc

Electronic Disbursement Authorization


 

Electronic Disbursement Authorization/Autorizacion Para Pago Electronico

I, , authorize Urban Select Realty Inc to disburse any available funds from my sales transactions to the following account:

Titular de la Cuenta/Name on the Account:  

Banco/Bank:

Routing Number:

Numero de Cuenta/Account Number:

 

 

Leave this empty:

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Signature Certificate
Document name: Electronic Disbursement Authorization
lock iconUnique Document ID: cea9bcfd533cb701a949496a4a6506dde919cbe0
Timestamp Audit
December 29, 2023 6:39 am ESTElectronic Disbursement Authorization Uploaded by Jose Miori - jose@urbanselectrealty.com IP 99.177.204.14