November 08, 2019

5251 DTC Parkway, Suite 258, Robert V. Wiggins and Kimberly S. Wiggins
Greenwood Village, Colorado, 80111, 3274 NW Fairway Heights
United States Dr. Bend, Oregon
97703
DEPOSIT AUTHORIZATION
The undersigned hereby authorize(s) Merging Interests Inc. to initiate a deposit to the account identified below; and
authorize(s) and directs the financial institution maintaining the deposit account to permit described deposit
initiated by Merging Interests Inc. pursuant to this deposit authorization. Below fill out the information to assist
Merging Interests Inc, in identifying the account which deposits are to be made.

Account Information

. Checking Account Savings Account Financial institution:

Account Number: Routing Number:

ABA#: SWIFT Code:

Financial institution Address:

Fill out portion below if account is held by a credit union

Intermediary Bank: Routing Number:
Account Number: SWIFT Code:
ABA#:

Deposit options

Single Deposit

Single Deposit (only applicable if deposit exceeds $ 9,999.99 USD) Increment $

Signature of Account Holder

Multiple Account Payouts

In the event that there is more that one party involved in the transaction and multiple accounts are requested, Merging
Interests Inc. will require a deposit authorization from each person that is to receive funds. Only persons named on
the contract named above are accepted for deposits.