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<br />Merchant Services • 4 Northeastern Boulevard, Salem, NH 03079-1952 o www,chasepaymentech.com
<br />Phone: (603) 896.6000 . Fax: (603) 696-6715 • Merchant_Services@ChasePaymentech.com
<br />Note: When setflno un multinle bank accounts. nleasP nmmn/PfP a sanaratP form for Panh_
<br />-SECTION 9: 13ANK ACCOUNT,INFORMATION
<br />Check only one
<br />Settlement Currency In which 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 />1 6
<br />Resides
<br />1 7
<br />Option#1 ®
<br />USD
<br />USA
<br />A, E
<br />See section A Note section)
<br />Option #2 ❑
<br />CAD
<br />CAN
<br />B1 to B3 E
<br />Option #3 ❑
<br />USD
<br />CAN
<br />81 to B3, D3, D4, E
<br />Option #4 ❑
<br />USD
<br />Int'I
<br />C1 to C3, D1, D3, D4, E
<br />(list country funds are being deposited in
<br />(Swift Code: is to 11 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 requires both ACH ABA# and Fedwire#/Routln #,
<br />Option 95 ❑
<br />❑Euro, ❑GBP, ❑ JPY, ❑AUD, ❑
<br />Euro Bank or SAME as
<br />C1 and/or C2, C3, E
<br />HKD, ❑DKK, ❑CHF, ❑NOK, ❑SEK,
<br />presentment/settlementcurrency
<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 />131 to B3, D1, D4, E
<br />HKD, ❑DKK, ❑CHF, ❑NOK, ❑SEK,
<br />❑NZD, ❑ZAR
<br />SostIon ' � US BANK ACCOUNT INFORMATION
<br />select only one method of transfer)
<br />® ACH Transfer
<br />3
<br />2
<br />2
<br />1 2
<br />1 1
<br />1 6
<br />1 2
<br />1 7
<br />(ABA #)
<br />❑ Wire Transfer (See Note)
<br />(Fedwire#/Routing #)
<br />❑ Swift Transfer (see Note)
<br />(Swift Code: is to 11 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 requires both ACH ABA# and Fedwire#/Routln #,
<br />Special Wire Instructio2s L60 b tes
<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
<br />❑ Savings
<br />Province:
<br />EFT Branch Transit Number:
<br />I _I I I I I (required if settlement is USD)
<br />Company Name: (As appears on Bank Account)
<br />Postal Code: Country: Canada
<br />Revl1/18110 8 New Division/cboo
<br />
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