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° Please provide first last name and clearly indicate what each person Iisted should be given access to (Attach a separate page If ne: ry.
Name: Accass Type: ["| Transactlon Reporting Only [[-| Transaction Inltlation Only (If using processor VT) [C} Both
Name: Access Type: ["] Transaction Reporting Only [7] ‘Transaction Initiation Only (if using processor VT) [7] Both
Access Type: [“| Transaction Reporting Only [[7] Transaction Initlation Only (If using processor VT) [7] Both
Access Type: [J Transaction Reporting Only [| Transaction Initiation Only {If using processor
VT} [7] Both ,
PERSONAL GUARANTEE
‘To induce Paya-EFT to enter Into the Agreement, | the undersigned {the “Guarantor”}, guarantee to Paya-EFT the due and punctual payrnent and performance of . ..
any and all of the present or future, direct or indirect, absolute or contingent Indebtedness, obligations and liabilities of thie Merchantnamed on this Application {and
~ Its successors arid assigns) which arlse pursuant to of in conhiectian with the Agréement as they become due from time to time (collectively the “Liabilities”) - .-
tegatdless of the place or manner In which the Labllittes arise or are evidenced, In any currency, whether incuriéd by the Merchant alone or with another or others
and whether as prinelpal or guarantor. If thls Guarantee ls executed by more than one party, the obligations of ail partles executing thls Guarantee shall be joint and
several and each such party shall, therefore, be severally llable for all of the obligations guaranteed hereby, notwithstanding'any discharge or unenforceability of thé
obligations with respect to any other party executing this Guarantee, The Guarantor shall pay or perform the Liabilities Immediately on demand ‘without any .
-/requirement that payment or performance of any of the Liabilities has heen demanded from the Merchant. The Guarantor will pay and performithe Liabilities <7
without regard to (i) any equities between the Guarantor and the Merchant or the Guarantor anid Paya-EFT; or (ii) any defense or right of set-off, combination of -
accounts or appropriation or arly cross-claim which the Merchant or the Guarantor may have, The amount of the Liabilities at any time shall be deerried to be as
stated by Paya-EFT based on its records, absent manifest error, The Guarantor Walves all defenses to any action of proceeding to enforce thls Guarantee,
‘This Guarantee shall not be limited, lessened, réléased or discharged by thé recovery of any Judgment against the Merchant or any other person, by any Voluntary oF
involuntary liquidation, dissolution, winding-up, merger or amalgamation of the Merchant or any other person, by any sale or other disposition of all or substantially
all of the assets of the Merchant, or by any Judicial or extra-judictal receivership, Insolvency, bankruptcy, assignment for the benefit of creditors, réorganization, -
moratorium, arrangement, composition with creditors or other proceedings affecting the Guarantor, the Merchant or any other person. The Guarantor shall reim= ~
burse or indemnify Paya-EFT on demand for all costs and expenses {including legal fees and disbursements ona solleltorand-his-owr-client basis) pald or Incutred in
enforcing the Liabilities, This Guarafitee shall enue to the benefit of the successors and asslgns of Paya-EFT, This Guarantee Is binding upoh the Guarantor, and any |
~|hélrs, executors, legal representatives, siccessors and assigns of the Guarantor
and Is effective until the obligatians of the Guarantor hereunder have been :
permanently pald or performed in full. : : : ee : es - :
MERCHANT
AGREED AND ACCEPTED: | have read and agreeto the Personal Guarantee; eee Ee ale =
Personal Gliarantor Signature». ” Printed Name © . * |Title a os Dated
4x : .
-ACH AUTHOREATION
ACH Debit/Credit Authorization: Merchant hereby authorizes Paya:EFT in accordance with this Agreement to Initiate debit/credit entries to Mercha int’s
checking account, as Indicated per the attached copy of a volded check from same. The authority is to remaln in full forcé and effect until {a). One hundred
and twenty (120) days after Paya-EFT has received written notification from Merchant of its termination in such a manner as to afford Paya-EFT reasonable
opportunity to act on it, and (b} all obligations of Merchant to Paya-EFT that have arisen under this agreement have beéh ald in full. Moose
Bank NamesFive Star Bank -
Depository: Merchant’sbatch actly willbe put into ths acount, ion es | Aecount ae . :
Foes: Merchanv’s monthly feos / necessary charges wil he taken frm this acouné, Routing#: = : oo [Accounts
OU SSE EAE fei es /MERCHANTACCEPTANCE. : BAe :
By signing below, | the undersigned, acknowledge and agree that the POS Conversion, Paper Guarantee, Check 21+ Remote Check Deposit, Checks-By-Phone,
Checks-By-Web, and ACH Debit/Credit services {Services”) provided pursuant to this merchant application (“Application”) aire provided by Paya EFT; inc.
{"Paya-EFT”}.| further represent to Paya-EFT that | have read the terms and conditions (“T&Cs”) attached to this Application and that | am authorized to sign
and accept the T&Cs.on behalf of the entity listed below (Merchant”), | acknowledge and agree that thé Merchant desires to use the Services In accordance
with the T&Cs and that the T&Cs together with this Applicattan, ifaccepted by Paya-EFT, create a legal agreement between the Paya-EFT and the Merchant
(“Agreement”) separate and distinct from any other services offered in ‘connection with the Paya-EFT Services, .
On behalf of the Merchant | will ensuré that the T&Cs aré reviéwed and agreé that they will bé bInding on the Merchant upon the use of the Paya-EFT
account Issued to the Merchant.
I certify to Paya-EFT that the Information provided in thts Application Is true, complete and accurate. | authorize Paya-EFT to verify the Information on this
Application and consent to the collection, use and disclosure of personal Information about me for this purpose..| consent to the sharing of credit infarmation
about.me or the Merchant with credit reporting agencies or credit bureaus as well as entities the Merchant purports to havea financial relationship and to
use of third party databases to obtain or verify information about the Merchant and Its financial condition.
MERCHANT MUST SUBMIT A VOIDED CHECK WITH THIS AGREEMENT
MERCHANT AGREED AND ACCEPTED: { have'read and agree to the Terms of this Agreement.
EEE
Not'valid unless approved and signed by dutharized of cer of Paya EFT
Application for Merchant Account — Check and ACH Processing REVO5152023 Page 3 of 11
PLEASE NOTE: The complete Merchant Agreement includes this Application and the Terms and Conditions on eight (8] additional pages.