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MM <br />CHASE A:# Merchant Services - 4 Northeastern Boulevard Salem. NH 03079,1952 - mwvchasepaymemcch corn <br />Phone. (603) 896-6000 - Fax: (603) 896-8715 - h4efchant—SeNices@ChasePayinentech.com <br />Date: 3131116 <br />MUM <br />AgreemenVNew Division Request <br />Company ID#: <br />Projected Live Date: <br />7/1/16 <br />SECTION 1: COMPANYICONTACT INFORMATION <br />Company Legal Name: Invoice Cloud, Inc <br />Company Taxpayer ID#: 263972596 <br />Contact Name: Robert Lapides Phone #: (781) 848-3733 EXT 223 <br />Fax #i 877-256-8330 Email Address: blapides@invoiceelaud.com <br />Transactions processed for this now set up request belong to: <br />Merchant whose company legal name is represented above... <br />OR <br />An Additional Company whose legal name is: _gLity_2f Santa Ana and is a 171 wholly-owned <br />E3 partially owned RI affiliate El registered DBA or [I Other (explain: of the merchant noted above. <br />On behalf of Invoice Cloud Inc <br />(Company Legal Name) <br />I Robert Lapides EVP <br />(Print Name) (Title) <br />verify that the account set-up information is accurate, that I have the authority to make such a request and <br />thus, it should be used to set u an additional account for our com an . <br />SECTION 2: BUSINESS UNIT if different from division name) <br />Parent Business Unit Cup to Parent Bus.Unit # <br />Name (if applicable): (if applicable): <br />Business (up to 30 bytes) Business Unit M <br />SECTION 3: FUNqN2_ffnew bankin see section 9 <br />If funds should be deposited to an wdsting bank account Please complete the following: <br />If USD or CAD, will funds be deposited into your existing Bank Account set up with Chase Paymentech? 0 Yes or EjNo <br />If yes, Bank Account# (Section 9 does not need to be completed) <br />If funds should be deposited to an existing funds transfer instruction please complete the Loilowin <br />If USD or CAD, will this division utilize an existing Funds Transfer Instruction (FTI)?[] Yes or E]No ffna, a now Fri will be created <br />If yes, provide FTI # (Section 9 does Not need to be completed) <br />Rev1 V 18010 1 NewDivisionSetupictioc, <br />