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Online Check Writer

111 N Marker St, San Jose, CA


408 775 7720

ACH Credit/Debit Authorization Form

By completing and executing this ACH Credit/Debit Authorization Form (the “Form”), I (we) hereby
authorize OnlineCheckWriter (OCW) to electronically initiate credit/debit entries in my (our) account to
correct any transactional errors and, if necessary, to electronically credit/debit my (our) account.

Please complete the information below:

Company Name Michael Loporchio Signed From 47.185.181.176 ip

Billing Address 2A Fairwayy Dr Phone# +13212654692

City, State, Zip SMITHFIELD RI 02917-1965 Email veronicafstrack@hotmail.com

Bank Account Name: MICHAEL L LOPORCHIO

Bank Name: 57-12/115

Bank Account Number: 24615994

Bank Routing #: 011500120

This Business Bank Account is Enabled for ACH Transactions : Yes

I certify that I am an authorized representative of the Company indicated above and that I have the authority to authorize these payments on the
Company’s behalf, and I am responsible for providing accurate account information for the purpose of the credit/debit through OCW platform.
The Company will hold OCW fully harmless and indemnified for any liability if this authorization is invalid or the account information provided
is incorrect or the credit/debit is made to an incorrect account. The Company understands that this authorization will remain in effect until it is
canceled in writing, and agrees to notify OnlineCheckWriter in writing of any changes in its account information or termination of this
authorization at least 15 days prior to the next draft/billing date. It will remain in force for a minimum of 1 year from the date of the last
transaction originated unless OCW terminates it earlier. The Company acknowledges that any changes an authorized representative makes to
account information via an online Customer Portalwill be considered written notice of change and will constitute authorization to charge the new
account in place of the account identified on this form.If the above noted payment dates fall on a weekend or holiday, the Company understands
that the payments may be executed on the next businessday. The Company understands that because these are electronic transactions, these funds
may be withdrawn from its account as soon as theabove noted transaction dates arrive, and that it will have limited time to report and dispute
errors. Should a debit be returned for any reason afterthe initiation of the credit, OCW will immediately hold any credit pushes or Digital Tokens,
will debit the account and will no longer process creditsuntil the transaction has been honored. In the case the transaction is returned for Non
Sufficient Funds (NSF) the Company understands thatOnlineCheckWriter may at its discretion attempt to process the transfer again within 30
days, and the Company agrees to an additional $30.00charge for each attempted return for NSF, which will be treated as a separate transaction
from the authorized payment. The Company has certifiedthat the above business bank account is enabled for ACH transactions, and agrees to
reimburse OCW for all penalties and fees incurred as a resultof the Company’s bank rejecting ACH debits or credits as a result of the account not
being properly configured for ACH transactions. Both partiesagree to be bound by NACHA Operating Rules as they pertain to these transactions.
The Company acknowledges that the origination of ACHtransactions to its account must comply with all relevant state and federal laws of the
United States. The Company agrees not to dispute thesescheduled transactions with its bank provided the transactions correspond to the terms
indicated in this Authorization Form.

MICHAEL LOPORCHIO
SIGNATURE Electronically signed from ip address DATE 06/10/2021
47.185.181.176 at 06/10/2021 08:41 am CDT

NAME MICHAEL LOPORCHIO TITLE

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