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<br />Bank of America, N.A. <br /> <br />I <br /> <br />Bank of America oS> <br />~ <br /> <br />Please provide the information requested below and forward to your sales representative or client relations <br />manager. Keep a copy for your records. <br /> <br />Legal business name <br /> <br />DBA name <br /> <br />Merchant signature <br /> <br />By signing below, the Merchant named above (1) acknowledges receipt of the Electronic Check Service <br />Agreement booklet entitled "Electronic Check Service" Agreement (2) agrees that Merchant and each <br />Electronic Check Service transaction submitted to Bank of America, N.A. will be bound by the terms and <br />conditions in that 1f. eement. <br /> <br />,5) . ~Yf- <br /> <br />Merchant signature <br /> <br />o Ar-J (S t...., <br />Print nameJtitle <br /> <br />I <br /> <br />(c ~ ~, <br /> <br />Date <br /> <br />1/,"-' ~ <br /> <br />t'f. ~'^"- <br />~ v <br /> <br /> <br /> <br />f <br />'~ 0 <br /> <br />B <br />IJ J rJ ~ ft <br />Print name/title <br /> <br /><:1// <br /> <br />Guarantor signature <br /> <br />D Check here if merchant is a privately held corporation, limited partnership or a limited-liability <br />company. If so, the principal owner(s) must sign below, agreeing to the Continuing Guaranty <br />provided in the Agreement. <br /> <br />Guanmtor signature <br /> <br />Date <br /> <br />Print name/title <br /> <br />~ <br /> <br />Merchant Services copy <br /> <br />I <br />