ACH AUTHORIZATION
1_Elizeheth Sulazay Authorize the STATE BANK OF CHANDLER to initiate debit(s), and any
credit(s) necessary to correct errors, to complete the following payments from MY ACCOUNT at the
DEPOSITORY:
Payment Description: loan 2asjmeat - Lueeklay
Payment Amount: §_ SO .00
Frequency: One-Time Monthly X] weekly Other
Authorization Type: New w Change (replaces a previous authorization)
Effective Date:
Termination Date: _[I-23-20a%
CREDIT INFORMATION:
Depository Name:_ Sale. F
Branch:_Chandler Phone: __SO7 72-220
city:__Ohwadlee State:_ fa) _.zIP:_ SWi22
Routing #:__OG1 AN» SY2 (voided check/draft/deposit slip attached.)
ACCOUNT #:_ 26100309 checking Loan
DEBIT INFORMATION:
Financial Institution Name:_Uniled Bank of Toca :
Branch: Phone:
City: .State:_TA zip: :
Routing #:_O73921433 ( L]voided check/draft/deposit slip attached.)
ACCOUNT #:__)GD0GU673S checking
This authorization will remain in effect until any termination date above, or until
(Z stare BANK OF CHANDLER receives written notice of termination from me in a time and manner allowing
the BANK and DEPOSITORY a reasonable opportunity to act on it.
Bg the of the bg
‘My account remains subject to its original terms, which are not altered by this authorization. | acknowledge this
payment or these payments must comply with the provisions of U.S. law.
Date Date