AUTHORIZATION AGREEMENT FOR TRANSFER AND PAYMENT EXCHANGE

Signer Account Details

CANCELLATION: This authorization will remain in full force and effect until EITHER Local Motion, LLC. or the above named has given written notification of its termination.

Same Day Exchange

(*$30 administrative fee for same day transfers.)

Commercial Branch Bank

(*FREE – Payments delivered every Friday.)

Transfer Authorization

I hereby authorize Local Motion, LLC, to initiate Debit and/or Credit entries to the either the Same-Day Exchange, Checking, or Savings account indicated in this form to or from the financial institution named. I acknowledge that the origination of transactions to my account or the withdrawal of funds from my account must comply with provisions of US law and accompany a signed  agreement or invoice for services renderer.

Note: Please allow seven (7) days for underwriting and establishment of your account.