ACH AUTHORIZATION AND DISCLOSURE

ACH AUTHORIZATION AND AGREEMENT

I acknowledge that the “Transfer Funds” feature allows me to electronically transfer funds via the

Automated Clearing House (“ACH”) between my eligible account(s) and my external account(s)

at other financial institutions (“External Account(s)”) once I have successfully registered my

External Account(s). This includes:

One-time on-demand transfers, which allow me to initiate multiple, non-recurring,

individual transfers based on the transfer date and dollar amount that I request through

the Transfer Funds feature of Online and Mobile Banking from time to time;

Recurring transfers, which allow me to initiate recurring transfers of a set dollar amount at

regular intervals that I have established through the Transfer Funds feature of Online and

Mobile Banking; and/or

Other ACH transfer features that Paybotic Financial may make available.

Subject to the terms of the Transfer Funds feature and the terms of my other agreements with

Paybotic Financial, I hereby authorize Paybotic Financial to initiate electronic credit/debit entries

to my eligible Paybotic Financial account(s) and each registered External Account indicated

previously for (a) various amounts at varying times by making on-demand transfers pursuant to

my instructions, and/or (b) fixed amount at the frequency I have selected by making recurring

transfers pursuant to my instructions (a “Preauthorized Transfer”). If any transfer date falls on a

weekend or bank holiday, I understand and agree that the transfer may be executed on the next

business day, or as soon as reasonably possible at the discretion of Paybotic Financial.


I hereby represent and warrant that I have all necessary right, power and authority to debit and

credit my Paybotic Financial account and any External Account(s) registered, and that all

information or instructions that I provide to Paybotic Financial in relation to any ACH transfer is

complete and accurate. I agree that ACH transactions I authorize comply with all applicable law.

Should an incorrect amount be withdrawn from or deposited to my External Account(s) or my

Paybotic Financial account(s), I authorize Paybotic Financial to correct the error by

debiting/crediting my External Account(s) or my Paybotic Financial account(s).

This authorization is to remain in full force and effect until Paybotic Financial has received written

notification from me of its termination in such a time and in such a manner as to afford Paybotic

Financial a reasonable opportunity to act on it. For Preauthorized Transfers, I understand that it

is my responsibility to contact Paybotic Financial to stop or cancel a Preauthorized Transfer at

least three business days prior to the following scheduled payment. In either case, I will send

my notice to:

Paybotic Financial: 1800 S Australian Ave, #400, West Palm Beach, FL 33409

I acknowledge that the origination of ACH transactions must comply with the provisions of

applicable law and the rules of the National Automated Clearing House Association (NACHA). I

request the financial institution that holds my External Account(s) to honor all transfers initiated in

accordance with this authorization form.External Account Routing Number:

External Account Number:

I agree to print this ACH Authorization and retain a hard copy or save as an electronic copy.

[Customer signature collected electronically]

Customer:

Consent ID:

Date:

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