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EFT Authorization Form

ROBERT V. JENSEN, INC.

AUTHORIZATION AGREEMENT FOR AUTOMATIC PAYMENT WITHDRAWAL

CUSTOMER NAME:

CUSTOMER NUMBER:

ADDRESS:

CITY:

STATE:

ZIP CODE:

PHONE:

FAX:

CUSTOMER hereby authorizes ROBERT V. JENSEN, INC. (COMPANY), to initiate entries to CUSTOMER checking account indicated below and the BANK named below. The amount of the entries shall be the total of the outstanding invoices due the COMPANY by the CUSTOMER in accordance with the COMPANY payment policy. Invoices will be drafted based upon due date stated on invoice.

CUSTOMER will be notified by fax of the specific invoices to be paid including document references and amounts, at least 24 hours prior to the draft date. Such notice will report the net amount of the debit and the effective date of the transaction. The effective date is the date the funds will be withdrawn from CUSTOMER account.

BANK:

BRANCH:

CITY:

STATE:

ZIP CODE:

TRANSIT/ABA NUMBER:

ACCOUNT NUMBER:

CUSTOMER agrees to maintain sufficient funds in the above-designated commercial BANK account to pay EFT debit entries when initiated. Should the debit entry be rejected by the BANK for any reason, CUSTOMER agrees to pay all BANK fees, processing charges, attorney fees, and other direct costs associated with the transaction, including finance charges that may accrue on the unpaid balance in accordance with COMPANY payment policy.

In the event of insufficient funds, COMPANY reserves the right to immediately terminate this agreement and/or, at COMPANY’S discretion, require cashier’s check, money order, pre-payment or other approved means of payment for the returned item. COMPANY will charge an insufficient funds fee of 1% of the EFT amount or $50.00 whichever is greater per returned EFT item. CUSTOMER will be advised that no additional shipments will be made until payment for the returned item and any related fees has been collected.

This authority is to remain in full force and effect until COMPANY and BANK have received written notification from CUSTOMER of its termination. CUSTOMER shall be required to give fifteen (15) days’ written notice of the termination of this agreement via certified mail, postage prepaid, return receipt requested; provided, however, that if the account is terminated and a similar account is not promptly established with another financial institution, COMPANY in its sole discretion, and notwithstanding any other agreement to the contrary, may determine what different credit terms, if any, will be thereafter offered to CUSTOMER.

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Timestamp

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July 18, 2019 5:06 am PST

EFT Authorization Form Uploaded by RV Jensen Admin - credit@rvjensen.com IP 206.169.107.66

July 30, 2019 1:44 pm PST

Eddie Montoya - emontoya@bctconsulting.com added by BCT Admin - bctdevelopers3@gmail.com as a CC'd Recipient Ip: 192.168.5.131

August 2, 2019 4:42 am PST

Eddie Montoya - emontoya@bctconsulting.com added by BCT Admin - bctdevelopers3@gmail.com as a CC'd Recipient Ip: 192.168.21.130

November 6, 2019 6:15 am PST

Eddie Montoya - emontoya@bctconsulting.com added by BCT Admin - bctdevelopers3@gmail.com as a CC'd Recipient Ip: 192.168.24.67

June 23, 2020 9:23 am PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 206.169.107.66

June 23, 2020 9:56 am PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 206.169.107.66

June 24, 2020 1:58 am PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 202.8.125.170

June 24, 2020 2:20 am PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 202.8.125.170

June 24, 2020 2:23 am PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 202.8.125.170

June 29, 2020 2:29 pm PST

Credit Dept - credit@rvjensen.com added by RV Jensen Admin - credit@rvjensen.com as a CC'd Recipient Ip: 206.169.107.66