SurePay Authorization Form

If submitted by the 15th, SurePay will go into effect around the 10th of the following month.

Note: If the 10th falls on a Saturday, your payment will be deducted on the 9th. If the 10th falls on a Sunday or holiday, your payment will be deducted on the next business day.

Terms & Conditions →

Owner Details

First Name

Last Name

Association

Unit Number

Hawaiiana Account Number

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Phone Number

Email Address

Bank Account Information

Your Financial Institution

9-Digit Routing Number

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Account Number

Type of AccountSelect OneCheckingSavings

Attach Voided Check or Bank Statement
Choose FileNo file chosen

Please attach a voided check from your financial institution or statement for account verification. A request for SurePay cancellation must be received by the 15th of the month in order to take effect the following month.

I authorize Hawaiiana Management Company, Ltd. (Hawaiiana), as Agent for my Association, to begin deductions from my account with the financial institution named in the Online Surepay Form for payment of my Association Charges. I also agree to payment of any handling fee charged for SurePay payment that cannot be processed due to insufficient funds, stop payment or account closure.

If I wish to terminate my automated SurePay payment, I understand that I must:

1. Submit an Online Cancellation Form to Hawaiiana OR
2. Send a letter of notification to Hawaiiana.
3. The Online Cancellation Form OR letter of notification must be received by the 15th of the month to terminate service for the following month; otherwise termination will take place after the following month's payment.

If Hawaiiana Management Company, Ltd. wishes to terminate SurePay service, the company will send a letter of notification to me. This letter will be mailed 20 days prior to the next SurePay payment for the termination to be effective.

View the Consent and Notice Regarding Electronic Communication →

Type your name in the *Signature Block*. By typing in your name, you are signing this form electronically and you agree your electronic signature is the legal equivalent of your manual signature on this form and that you are authorizing the changes you have made on this form.