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CHASE Cp,.
<br />Paynnentech
<br />Merchant Services • 4 Northeastern Boulevard, Salem, NH 03079.1952 • www.chasepaymentech.com • '
<br />Phone: (603) 896-6000 •. Fax: (603) 896-6715 • Merchant_Services@ChasePaymentech.cwm
<br />Nnfa• When coHlnn un mrdHnin hank aer-nunfa_ nlaaca rmmnlafe a canarate form for each"
<br />SECTION 9: '.BANK ACCOUNT: I N FORMATION . ..
<br />Check only one .
<br />Settlemerit Currency In whlah we
<br />Deposit
<br />Complete all sections .
<br />of the 7 options
<br />will fund to you
<br />(Country Where your Bank. Acct
<br />.listed:
<br />below.
<br />Resides)* '
<br />Please Note: Swift code is required if your division is located outside of the US or Canada and is settling funds in USD.
<br />Wire transfer re ulres hoth ACH ABA# and Fedwlre#/Routin .
<br />Option #10
<br />USD
<br />USA
<br />A, E
<br />Bank Account #: 935309500 Company Name: (As appears on Bank Account)
<br />Financial Institution Name: J.P Morgan
<br />City: Irvine State: CA Zip/Postal Code: 92614
<br />® Checking OR ❑ Savings
<br />See section A Note section
<br />Option #2 0
<br />CAD
<br />CAN
<br />B1 to B3 E
<br />Option #3 El
<br />USD
<br />CAN
<br />B1 to B3 D3 D4, E
<br />Option #4 ❑
<br />USD
<br />Int'I
<br />C1 to C3, D1, D3, D4, E
<br />list count funds are being deposited in
<br />Option 95 ❑
<br />❑Euro, ❑GBP, ❑ JPY, ❑AUD, ❑
<br />Euro Bank or SAME as
<br />Cl and/or C2, C3, E
<br />HKD, ❑DKK, ❑CHF, ❑NOK, ❑SEK,
<br />presentment/settlement currency
<br />❑NZD, ❑ZAR
<br />Option # 6 ❑
<br />❑Euro, ❑GBP, ❑ JPY, ❑AUD, ❑
<br />If DIFFERENT than Settlement
<br />C1 and/or C2, C3, D1
<br />HKD, ❑DKK, ❑CHF, ❑NOK, ❑SEK,
<br />Currency
<br />and/or D2, D4, E
<br />❑NZD, ❑ZAR, ❑USD
<br />Int'I
<br />list country funds are being deposited in
<br />Option #7 ❑
<br />❑Euro, ❑GBP, ❑ JPY, ❑AUD, ❑
<br />CAN
<br />B1 to B3, D1, D4, E
<br />HKD, ❑DKK, ❑CHF, ❑NOK, ❑SEK,
<br />NZD ❑ZAR
<br />9e660h*. -US BANK ACGOUN'( INF'ORMAT1f5N
<br />select only one method of transfer
<br />N ACH Transfer 3
<br />1 2 1 2 2 7 1 6 2
<br />7 (ABA #)
<br />❑ WireTransfer (See Note)
<br />(FedwireWRouting #)
<br />❑ Swift Transfer (see Note)
<br />(Swift Code: is to it bytes)
<br />Please Note: Swift code is required if your division is located outside of the US or Canada and is settling funds in USD.
<br />Wire transfer re ulres hoth ACH ABA# and Fedwlre#/Routin .
<br />Special Wire Instructions: 60 b es
<br />Bank Account #: 935309500 Company Name: (As appears on Bank Account)
<br />Financial Institution Name: J.P Morgan
<br />City: Irvine State: CA Zip/Postal Code: 92614
<br />® Checking OR ❑ Savings
<br />City of Santa Ana
<br />Country: United States
<br />131 Institution Number.
<br />B2 Swift Code: (8 to 11 bytes)
<br />B3 Bank Account#
<br />Financial Institution Name:
<br />City:
<br />❑ Checking OR ❑ Savings
<br />Province:
<br />EFT Branch Transit Number:
<br />(required if settlement is USD)
<br />Company Name: (As appears on Bank Account)
<br />Postal Code: Country: Canada
<br />Rev11/18/10 25Q-47 New Division/cboo
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