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<br />I <br /> <br />,~ I <br /> <br /> <br />Bank of America, N.A. <br /> <br />Banko' America ~ <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 tmnsaction submitted to Bank of America, NA will be bound by the terms and <br /> <br />COnditiODS l!~ Ajemen> <br />--- J <br />o ?\ lJ t} Le It}.) <br />Print name/title <br /> <br />Date <br /> <br />9/" fC\1 <br /> <br /> <br />~(/J' <br /> <br /> <br />}) 0 (Il tJ {\ <br />Print name/title <br /> <br />Guarantor signature <br /> <br />o Check here if merchant is a privately held corporation, limited parlneIship 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 />Guarantor signature <br /> <br />Date <br /> <br />Print name/title <br /> <br />~ <br /> <br />Merchant copy <br />