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ELECTRONIC FUNDS TRANSFER ("EFT") AUTHORIZATION AGREEMENT
| Customer Name:___________________________________Customer #:__________ |
| Customer Address:__________________________City:_____________________ State:_____ Zip:_________ |
| Customer Account Contact | Phone | Fax | Easylink No. |
| Customer Financial Institution Name | |||
| Bank Address | City | State | Zip |
| Bank Account Contact | Bank Phone No. | ||
| Customer Bank Account and Bank Routing (ABA) Number (Micr #) **Please include a copy of a voided check** | |||
The above named person or company, hereinafter called CUSTOMER, hereby authorizes TON Services, Inc. to originate an Automated Clearing House electronic funds transfer credit/debit entry to CUSTOMER'S demand deposit account indicated above and hereby authorizes the Depository Institution named above, hereinafter called Financial Institution, to accept and to credit or debit the amount of such entries to CUSTOMER'S demand deposit account.
The Automated Clearing House Electronic Funds Transfer credit and debit entry shall be initiated by First Security Bank, Brigham City, Utah on behalf of TON. The Financial Institution will receive pre-notification of the Automated Clearing House electronic funds debit entry 10 days prior to the initial debit entry.
This authority shall remain in effect until 30 days after Financial Institution, at the address shown above and TON at the address shown below, have received written cancellation from CUSTOMER. Notice of cancellation shall not affect debit or credit entries initiated prior to the 30th day following Financial Institution and TON's actual receipt of notice.
CUSTOMER understands that the Automated Clearing House electronic funds transfer debit entry will only be accepted by Financial Institution if sufficient funds are available in CUSTOMER'S demand deposit account, and CUSTOMER agrees separately with TON to deposit adequate funds prior to each EFT debit made by TON into customer's demand deposit account. In the event any entry is not accepted for any reason, Financial Institution is to notify TON by telephone at the telephone number shown below by the close of the banking day on which this entry is presented. CUSTOMER agrees to pay TON immediately all sums refused by Financial Institution for transfer to TON. Interest shall accrue on such sums at the rate of 18% per annum or the highest rate allowed by law, which ever shall be less from the date of attempted debit until paid in full. CUSTOMER shall pay TON all expenses incurred by TON in collecting unpaid sums including but not limited to reasonable attorney fees, court costs, and collection agency costs. In the event TON electronically debits customer's account in an amount less than $500, TON may pass the electronic debit charges to CUSTOMER, and may collect the same in that or any subsequent debit.
CUSTOMER understands that if CUSTOMER refuses or otherwise fails to make payment for a debit entry, this agreement and all other agreements between CUSTOMER and TON may be terminated by TON at TON's sole discretion.
| CUSTOMER Authorization | ||
| Authorized Signature ________________________________Title_______________Date__________ | ||
| Financial Institution Acceptance | ||
| Authorized Signature_________________________________Title_______________Date__________ | ||
| TON SERVICE (For office use) | ||||
| Signature | Title | Date | ||
| Phone No. | ||||
| Address | City | State | Zip Code | |
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