FUNDS TRANSFER AUTHORIZATION AGREEMENT Sample Clauses

FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to directly deposit commission checks electronically into a bank account designated by the Producer. Producer hereby authorizes Company to CREDIT entries to the account indicated below at the financial institution named below hereinafter referred to as “Depository.” Telephone Routing Number Account Number Producer Name Producer Code: (Avatar completes) This authorization is to remain in force and effect until Company has received written notification from Producer of its termination in such time and manner as to afford Company and Depository a reasonable opportunity to process the termination. Producer Signature: A. VOIDED CHECK (FUNDS TRANSFER CANNOT BE ACTIVATED WITHOUT AVOIDED CHECK) B. W-9. C. COPY OF YOUR CURRENT “E & O” DEC PAGE. D. COPY OF AGENCY PRINCIPAL’S 220 LICENSE. XXXXXXXX Rate # of Policies Written* 12% 0 - 10 XXXXXX XXXXXX HIGHLANDS XXXXXX XXXXXXX XXXXXXXXX LAKE XXXX LIBERTY XXXXXXX XXXXXX OKEECHOBEE ORANGE OSCEOLA POLK XXXXXX SEMINOLE SUMTER SUWANNEE UNION WASHINGTON Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service See Specific Instructions on page 2. 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶ Other (see instructions) ▶ Exemption from FATCA reporting code (if any)
Sample 1
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FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to directly deposit commission checks electronically into a bank account designated by the Producer. Producer hereby authorizes Company to CREDIT entries to the account indicated below at the financial institution named below hereinafter referred to as “Depository.” Telephone Account Type Checking ☐ Savings ☐ Routing Number Account Number Producer Name Producer Code (Avatar completes) This authorization is to remain in force and effect until Company has received written notification from Producer of its termination in such time and manner as to afford Company and Depository a reasonable opportunity to process the termination. Producer Signature: Effective Date: _ It is mutually understood and agreed as follows: The Agent shall be entitled to receive as its sole commission and payment for any insurance coverage written under the Voluntary Agreement the commission rates defined below. The rate of commission payable to the Agent will be based on the commissionable policy premium received. No commissions are payable on any policy fees and surcharges. Commission payable under this contract applies as provided below: Product New Business (all counties except S FL) Renewal (all counties except S FL) South Florida* - New Business South Florida* - Renewal Homeowners 12% 10% 10% 10% Dwelling Fire Other *South Florida = Palm Beach, Broward, Monroe, Miami-Dade “AGENT” “COMPANY” By: By: Title: Title: Date: Date: Form W-9(Rev. December 2014)Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: Individual/sole proprietor or C Corporation S Corporation Partnership Trust/estate single-member LLC Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶ Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) ▶ 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):...
Sample 1
FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to directly deposit commission checks electronically into a bank account designated by the Producer. Producer hereby authorizes Company to CREDIT entries to the account indicated below at the financial institution named below hereinafter referred to as “Depository.” Depository Name: Telephone: Routing Number: Account Number: Producer Name: Producer Code: _(co rep completes) This authorization is to remain in force and effect until Company has received written notification from Producer of its termination in such time and manner as to afford Company and Depository a reasonable opportunity to process the termination. Producer Signature: PLEASE ATTACH THE FOLLOWING: 1. VOIDED CHECK (FUNDS TRANSFER CANNOT BE ACTIVATED WITHOUT A VOIDED CHECK) 2. W-9. 3. COPY OF YOUR CURRENT “E & O” DEC PAGE. 4. COPY OF AGENCY PRINCIPAL’S 220 LICENSE.
Sample 1
FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter “Authorization Agreement”) allows Company to collect premium payments electronically from a bank account designated by Producer. Producer may establish a new account solely for Company premium collection, or use and existing escrow account. Producer hereby authorizes Company to initiate DEBIT and CREDIT entries to the account indicated below at the financial institution named below, hereinafter referred to as “Depository.” Producer further authorizes Depository to accept such automatic deposits to or withdrawals from Producer’s account by Company and to automatically credit or debit, as the case may be, such amounts. Depository Name: Branch Name: City, State, Zip: Telephone: Routing Number: Account Number: Account Type: Producer Name: Producer Code: This authorization is to remain in full force and effect until Company has received written notification from Producer of its termination in such time and manner as to afford Company and Depository a reasonable opportunity to process the termination. If there is a change in any of the information relating to the account name, number, or address provided by Producer in this Authorization Agreement, Producer agrees to notify Company within ten (10) days of such change. Producer further agrees to notify Company within two (2) days if the account listed above is closed, seized, or frozen, or any other action is taken upon the account by Depository or any other entity that would affect the debiting or crediting of funds to the account. This Authorization Agreement is non-negotiable and non-transferable. Producer authorizes Company to debit and credit the account listed above periodically in variable amounts as may be necessary to affect any Producer Agreement Producer has entered into with Company. Producer Signature: • PLEASE ATTACH A VOIDED CHECK FUNDS TRANSFER CANNOT BE ACTIVATED WITHOUT A VOIDED CHECK
Sample 1

Related to FUNDS TRANSFER AUTHORIZATION AGREEMENT

  • Stop Transfer Instructions In order to enforce the foregoing covenants, the Company may impose stop-transfer instructions with respect to the securities of each Holder (and the securities of every other person subject to the restrictions in Section 1.14(a)).

  • Authorization for Agreement The execution and performance of this ---------------------------- Agreement by Licensee and Manager have been duly authorized by all necessary laws, resolutions or corporate action, and this Agreement constitutes the valid and enforceable obligations of Licensee and Manager in accordance with its terms except as such enforceability may be limited by creditors rights laws and general principles of equity.

  • Stop Transfer Instruction The Company will instruct any transfer agent not to register the Transfer of any Shares until the conditions specified in the foregoing legends are satisfied.

  • Authorization of Underwriting Agreement This Agreement has been duly authorized, executed and delivered by the Company.

  • Authorization and Consent The Government has given its authorization and consent for all use and manufacture of any invention described in and covered by a patent of the United States in the performance of this Agreement or any part hereof or any amendment hereto or any subcontract hereunder (including any lower-tier subcontract) which is expected to exceed $100,000.

  • AGENT AUTHORIZATION FORM I/We, (Print Bidder name) , Do hereby authorize (print agent’s name), , to act as my/our agent to execute any petitions or other documents necessary to affect the CONTRACT approval PROCESS more specifically described as follows, (IFB NUMBER AND TITLE) , and to appear on my/our behalf before any administrative or legislative body in the county considering this CONTRACT and to act in all respects as our agent in matters pertaining TO THIS CONTRACT. Signature of Bidder Date STATE OF FLORIDA ) COUNTY OF ) The foregoing instrument was acknowledged before me by means of ☐physical presence, or ☐online notarization, this day of , 20 , by [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for [NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED]. ☐Personally Known; OR ☐Produced Identification. Type of identification produced: . [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] Notary Public My Commission Expires: (Printed, typed or stamped commissioned name of Notary Public) I affirm that an employee leasing company provides my workers’ compensation coverage. I further understand that my contract with the employee leasing company limits my workers’ compensation coverage to enrolled worksite employees only. My leasing arrangement does not cover un-enrolled worksite employees, independent contractors, uninsured sub-contractors or casual labor exposure. I hereby certify that 100% of my workers are covered as worksite employees with the employee leasing company. I certify that I do not hire any casual or uninsured labor outside the employee leasing arrangement. I agree to notify the County in the event that I have any workers not covered by the employee leasing workers’ compensation policy. In the event that I have any workers not subject to the employee leasing arrangement, I agree to obtain a separate workers’ compensation policy to cover these workers. I further agree to provide the County with a certificate of insurance providing proof of workers’ compensation coverage prior to these workers entering any County jobsite. I further agree to notify the County if my employee leasing arrangement terminates with the employee leasing company and I understand that I am required to furnish proof of replacement workers’ compensation coverage prior to the termination of the employee leasing arrangement. I certify that I have workers’ compensation coverage for all of my workers through the employee leasing arrangement specified below: Workers’ Compensation Carrier: A.M. Best Rating of Carrier: Inception Date of Leasing Arrangement: I further agree to notify the County in the event that I switch employee-leasing companies. I recognize that I have an obligation to supply an updated workers’ compensation certificate to the County that documents the change of carrier. Signature of Owner/Officer: Title: Date: If the bidder is submitting as a joint venture, please be advised that this form MUST be completed and the REQUESTED written joint-venture agreement MUST be attached and submitted with this form.

  • Wire Transfer Instructions I will wire funds from my outside account according to the “Subscription Instructions” Page. ____ I will wire funds from my Aegis Capital Account. ____The funds for this investment are rolled over, tax deferred from __________ within the allowed 60 day window.

  • Authorization; Binding Agreement The Company has all requisite corporate power and authority to execute and deliver this Agreement and each Ancillary Document to which it is or is required to be a party, to perform the Company’s obligations hereunder and thereunder and to consummate the transactions contemplated hereby and thereby, subject to obtaining the Required Company Stockholder Approval. The execution and delivery of this Agreement and each Ancillary Document to which the Company is or is required to be a party and the consummation of the transactions contemplated hereby and thereby, (a) have been duly and validly authorized by the Company’s board of directors in accordance with the Company’s Organizational Documents, the DGCL, any other applicable Law or any Contract to which the Company or any of its stockholders is a party or by which it or its securities are bound and (b) other than the Required Company Stockholder Approval, no other corporate proceedings on the part of the Company are necessary to authorize the execution and delivery of this Agreement and each Ancillary Document to which it is a party or to consummate the transactions contemplated hereby and thereby. This Agreement has been, and each Ancillary Document to which the Company is or is required to be a party shall be when delivered, duly and validly executed and delivered by the Company and assuming the due authorization, execution and delivery of this Agreement and any such Ancillary Document by the other parties hereto and thereto, constitutes, or when delivered shall constitute, the legal, valid and binding obligation of the Company, enforceable against the Company in accordance with its terms, subject to the Enforceability Exceptions. The Company’s board of directors, by resolutions duly adopted at a meeting duly called and held (i) determined that this Agreement and the Merger and the other transactions contemplated hereby are advisable, fair to, and in the best interests of, the Company, its Subsidiaries and its stockholders, (ii) approved this Agreement and the Merger and the other transactions contemplated by this Agreement in accordance with the DGCL, (iii) directed that this Agreement be submitted to the Company’s stockholders for adoption and (iv) resolved to recommend that the Company stockholders adopt this Agreement.

  • Disbursement Authorization Each Borrower hereby irrevocably authorizes Agent to disburse the proceeds of each Revolver Loan requested by any Borrower, or deemed to be requested pursuant to Section 3.1.1 or Section 3.1.3(ii), as follows: (i) the proceeds of each Revolver Loan requested under Section 3.1.1(i) shall be disbursed by Agent in accordance with the terms of the written disbursement letter from Borrowers in the case of the initial Borrowing, and, in the case of each subsequent Borrowing, by wire transfer to such bank account as may be agreed upon by any Borrower and Agent from time to time or elsewhere if pursuant to a written direction from such Borrower; and (ii) the proceeds of each Revolver Loan requested under Section 3.1.1(ii) or Section 3.1.3(ii) shall be disbursed by Agent by way of direct payment of the relevant interest or other Obligation. Any Loan proceeds received by any Borrower or in payment of any of the Obligations shall be deemed to have been received by all Borrowers.

  • Authorization of Agreement, Etc The Borrower has the right and power, and has taken all necessary action to authorize it, to borrow and obtain other extensions of credit hereunder. The Borrower and each other Loan Party has the right and power, and has taken all necessary action to authorize it, to execute, deliver and perform each of the Loan Documents to which it is a party in accordance with their respective terms and to consummate the transactions contemplated hereby and thereby. The Loan Documents to which the Borrower or any other Loan Party is a party have been duly executed and delivered by the duly authorized officers of such Person and each is a legal, valid and binding obligation of such Person enforceable against such Person in accordance with its respective terms except as the same may be limited by bankruptcy, insolvency, and other similar laws affecting the rights of creditors generally and the availability of equitable remedies for the enforcement of certain obligations (other than the payment of principal) contained herein or therein may be limited by equitable principles generally.

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