Common use of FUNDS TRANSFER AUTHORIZATION AGREEMENT Clause in Contracts

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

FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to collect premium payments directly deposit commission checks electronically from into a bank account designated by the 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, below hereinafter referred to as “Depository.” Depository Name Telephone Account Type Checking ☐ Savings ☐ Routing Number Account Number 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: Name Producer Name: Producer Code: Code (Avatar completes) 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 CHECKEffective Date: _ ADDENDUM I. COMMISSION SCHEDULE 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 EFFECTIVE DATE OF COMMISSION RATE AMENDMENT: “AGENT” “COMPANY” By: By: Title: Title: Date: Date: Avatar Property & Casualty Insurance 0000 X Xxxxxxxxxx Xxx Xxxxx 000, Xxxxx, XX 00000 Phone: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 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. 2 Business name/disregarded entity name, if different from above 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): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 0 Xxxxxxx (xxxxxx, xxxxxx, xxx xxx. or suite no.) Requester’s name and address (optional)

FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to collect premium payments directly deposit commission checks electronically from into a bank account designated by the 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, below hereinafter referred to as “Depository.” Depository Name Telephone Account Type Checking ☐ Savings ☐ Routing Number Account Number 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: Name Producer Name: Producer Code: Code (Avatar completes) 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 CHECKEffective Date: _ ADDENDUM I. COMMISSION SCHEDULE 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 EFFECTIVE DATE OF COMMISSION RATE AMENDMENT: “AGENT” “COMPANY” By: By: Title: Title: Date: Date: Avatar Property & Casualty Insurance 0000 X Xxxxxxxxxx Xxx Xxxxx 000, Xxxxx, XX 00000 Phone: (000) 000-0000 Toll Free: (000) 000-0000 Fax: (000) 000-0000 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. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Print or type See Specific Instructions on page 2. 2 Business name/disregarded entity name, if different from above 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): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 0 Xxxxxxx (xxxxxx, xxxxxx, xxx xxx. or suite no.) Requester’s name and address (optional)

FUNDS TRANSFER AUTHORIZATION AGREEMENT. Completing this Funds Transfer Authorization Agreement (hereinafter referred to as “Authorization Agreement”) allows Company to collect premium payments directly deposit commission checks electronically from into a bank account designated by the 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, below hereinafter referred to as “Depository.” Depository Name Telephone Account Type Checking ☐ Savings ☐ Routing Number Account Number 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: Name Producer Name: Producer Code: Code (Avatar completes) 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 Effective Date: _ ADDENDUM I. COMMISSION SCHEDULE 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 Line New Business Renewal Personal 10% 8% Commercial 10% 10% EFFECTIVE DATE OF COMMISSION RATE AMENDMENT: SEPTEMBER 1, 2020 AGENT COMPANY BY: BY: TITLE: TITLE: DATE: DATE: THE PRODUCER MAY BE ELIGIBLE FOR A VOIDED CHECK FUNDS TRANSFER CANNOT BONUS FOR SERVICES DURING THE CALENDER YEAR PERIOD. THE PRODUCERS ELIGIBILITY TO RECEIVE A BONUS, ANY DETERMINATION TO AWARD THE PRODUCER SUCH A BONUS AND, IF AWARDED, THE AMOUNT THEREOF SHALL BE ACTIVATED WITHOUT WITH AVATAR’S SOLE DISCRETION. THE COMPANY WILL PAY AN ADDITIONAL 3% ANNUAL COMMISSION BONUS COMMENCING WITH CALENDAR YEAR 2021, IF THE PRODUCER HAS A VOIDED CHECKMINIMUM OF 25 POLICIES IN FORCE OR 5 COMMERCIAL POLICIES IN FORCE AND THE FOLLOWING CRITERIA IS MET: