c by authorize and agree to allow Aspen Square Management, Inc., on behalf of to Landlotd, to time V,TS / MastesCard Debit (CIRCLE ONE). Name on Credit/Debit Cord Address City State ZIP Credit/Debit Card Numb on 0 so° Amount $ N. 5 Reason for Payment Air Sissed this - - day of N.1. psident/Ap