Common use of Returned or Stop Payment on Checks Clause in Contracts

Returned or Stop Payment on Checks. I agree to pay the University of California a $10.00 service charge for any service charges. HOME ADDRESS SIGNATURE CITY/STATE/ZIP SOCIAL SECURITY NUMBER MOBILE TELEPHONE CAMPUS HOME DEPARTMENT PAGER/WORK TELEPHONE CAMPUS ADDRESS/BOX NO. Xxxxxxxx Loan Applicant Payment Schedule Agreement Name: Employee ID # : Department: Appointment End Date: REMAINING DURATION OF TRAINEE APPOINTMENT MINIMUM MONTHLY PAYMENT $1,200 LOAN MINIMUM MONTHLY PAYMENT $2,400 LOAN FINAL PAYMENT DUE 12 months or longer $100.00 $200.00 Last month of the academic year 10 months $120.00 $240.00 Last month of the academic year 8 months $150.00 $300.00 Last month of the academic year 6 months $200.00 $400.00 Last month of the academic year 5 months $240.00 $480.00 Last month of the academic year I agree to the terms of payment as set forth in the above schedule. Signature of Resident/Fellow Date Revised 08/11/2016 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO BERKELEY  XXXXX  IRVINE  LOS ANGELES  RIVERSIDE  SAN DIEGO  SAN FRANCISCO SANTA XXXXXXX  SANTA XXXX ACCOUNTING OFFICE SAN FRANCISCO, CALIFORNIA 94143-0812 DATE PAYROLL DEDUCTION AUTHORIZATION TO: University of California, San Francisco I hereby authorize the University of California to make deductions from my salary checks in accordance with the following schedule: Monthly deductions of: $ Deductions beginning: This payment represents the monthly amount due to the Xxxxxxxx Loan Fund. Should termination of my appointment with UCSF occur before the repayment schedule has been completed, I understand that the University can deduct the balance owing from my final paycheck. Failure to abide by these terms will result in a breach of the promissory note. I understand that this authorization, which is effective immediately, cannot be revoked. __ Name, (please print) Social Security Number Signature Date FOR ACCOUNTING USE ONLY

Returned or Stop Payment on Checks. I agree to pay the University of California a $10.00 service charge for any service charges. HOME ADDRESS SIGNATURE CITY/STATE/ZIP SOCIAL SECURITY NUMBER (Last 4 only) MOBILE TELEPHONE CAMPUS HOME DEPARTMENT PAGER/WORK TELEPHONE CAMPUS ADDRESS/BOX NO. Xxxxxxxx Loan Applicant Payment Schedule Agreement Name: Employee ID # : Department: Appointment End Date: REMAINING DURATION OF TRAINEE APPOINTMENT MINIMUM MONTHLY PAYMENT $1,200 LOAN MINIMUM MONTHLY PAYMENT $2,400 LOAN FINAL PAYMENT DUE 12 months or longer $100.00 $200.00 Last month of the academic year 10 months $120.00 $240.00 Last month of the academic year 8 months $150.00 $300.00 Last month of the academic year 6 months $200.00 $400.00 Last month of the academic year 5 months $240.00 $480.00 Last month of the academic year I agree to the terms of payment as set forth in the above schedule. Signature of Resident/Fellow Date Revised 08/11/2016 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO BERKELEY  XXXXX  IRVINE  LOS ANGELES  RIVERSIDE  SAN DIEGO  SAN FRANCISCO SANTA XXXXXXX  SANTA XXXX ACCOUNTING OFFICE SAN FRANCISCO, CALIFORNIA 94143-0812 DATE PAYROLL DEDUCTION AUTHORIZATION TO: University of California, San Francisco I hereby authorize the University of California to make deductions from my salary checks in accordance with the following schedule: Monthly deductions of: $ _ Deductions beginning: _ This payment represents the monthly amount due to the Xxxxxxxx Loan Fund. Should termination of my appointment with UCSF occur before the repayment schedule has been completed, I understand that the University can deduct the balance owing from my final paycheck. Failure to abide by these terms will result in a breach of the promissory note. I understand that this authorization, which is effective immediately, cannot be revoked. __ XXXX-XXXX-XXXX- Name, (please print) Social Security Number (Last 4 only) Signature Date FOR ACCOUNTING USE ONLY

Returned or Stop Payment on Checks. I agree to pay the University of California a $10.00 service charge for any service charges. HOME ADDRESS SIGNATURE CITY/STATE/ZIP SOCIAL SECURITY NUMBER (Last 4 only) MOBILE TELEPHONE CAMPUS HOME DEPARTMENT PAGER/WORK TELEPHONE CAMPUS ADDRESS/BOX NO. Xxxxxxxx Loan Applicant Payment Schedule Agreement Name: Employee ID # : Department: Appointment End Date: REMAINING DURATION OF TRAINEE APPOINTMENT MINIMUM MONTHLY PAYMENT $1,200 LOAN MINIMUM MONTHLY PAYMENT $2,400 LOAN FINAL PAYMENT DUE 12 months or longer $100.00 $200.00 Last month of the academic year 10 months $120.00 $240.00 Last month of the academic year 8 months $150.00 $300.00 Last month of the academic year 6 months $200.00 $400.00 Last month of the academic year 5 months $240.00 $480.00 Last month of the academic year I agree to the terms of payment as set forth in the above schedule. Signature of Resident/Fellow Date Revised 08/11/2016 03/16/2020 SMF UNIVERSITY OF CALIFORNIA, SAN FRANCISCO BERKELEY  XXXXX  IRVINE  LOS ANGELES  RIVERSIDE  SAN DIEGO  SAN FRANCISCO SANTA XXXXXXX  SANTA XXXX ACCOUNTING OFFICE SAN FRANCISCO, CALIFORNIA 94143-0812 DATE PAYROLL DEDUCTION AUTHORIZATION TO: University of California, San Francisco I hereby authorize the University of California to make deductions from my salary checks in accordance with the following schedule: Monthly deductions of: $ _ Deductions beginning: _ This payment represents the monthly amount due to the Xxxxxxxx Loan Fund. Should termination of my appointment with UCSF occur before the repayment schedule has been completed, I understand that the University can deduct the balance owing from my final paycheck. Failure to abide by these terms will result in a breach of the promissory note. I understand that this authorization, which is effective immediately, cannot be revoked. __ XXXX-XXXX-XXXX- Name, (please print) Social Security Number (Last 4 only) Signature Date FOR ACCOUNTING USE ONLY

Returned or Stop Payment on Checks. I agree to pay the University of California a $10.00 service charge for any service charges. HOME ADDRESS SIGNATURE CITY/STATE/ZIP SOCIAL SECURITY NUMBER MOBILE TELEPHONE CAMPUS HOME DEPARTMENT PAGER/WORK TELEPHONE CAMPUS ADDRESS/BOX NO. Xxxxxxxx Loan Applicant Payment Schedule Agreement Name: Employee ID # : Department: Appointment End Date: REMAINING DURATION OF TRAINEE APPOINTMENT Remaining duration of trainee appointment MINIMUM MONTHLY PAYMENT $1,200 LOAN MINIMUM MONTHLY PAYMENT $2,400 LOAN FINAL PAYMENT DUE 12 months or longer $100.00 $200.00 Last month of the academic year 10 months $120.00 $240.00 Last month of the academic year 8 months $150.00 $300.00 Last month of the academic year 6 months $200.00 $400.00 Last month of the academic year 5 months $240.00 $480.00 Last month of the academic year I agree to the terms of payment as set forth in the above schedule. Signature of Resident/Fellow Date Revised 08/11/2016 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO BERKELEY  • XXXXX  • IRVINE  • LOS ANGELES  • RIVERSIDE  • SAN DIEGO  • SAN FRANCISCO SANTA XXXXXXX  • SANTA XXXX ACCOUNTING OFFICE SAN FRANCISCO, CALIFORNIA 94143-0812 DATE PAYROLL DEDUCTION AUTHORIZATION TO: University of California, San Francisco I hereby authorize the University of California to make deductions from my salary checks in accordance with the following schedule: Monthly deductions of: $ Deductions beginning: This payment represents the monthly amount due to the Xxxxxxxx Loan Fund. Should termination of my appointment with UCSF occur before the repayment schedule has been completed, I understand that the University can deduct the balance owing from my final paycheck. Failure to abide by these terms will result in a breach of the promissory note. I understand that this authorization, which is effective immediately, cannot be revoked. __ Name, (please print) Social Security Number Signature Date FOR ACCOUNTING USE ONLY