BRANCH: Enter the Name of the Branch Where the Account to Be Debited Is Located

BANK NAME: Enter the name of the bank where the account to be debited is located.

BRANCH: Enter the name of the branch where the account to be debited is located.

ADDRESS/CITY/STATE/ZIP: Enter the complete mailing address of the bank where the account to be debited is located.

TRANSIT ROUTING NUMBERS: Enter the transit routing numbers (eight digits that immediately precede the account number) of the bank where the account to be debited is located. NOTE: if nine digits are present, enter the ninth (least significant) digit in the transit ABA check digit box.

ACCOUNT NUMBER: Enter the account number of the account to be debited.

DEPOSITORS NAME: The name(s) in which the account to be debited is open.

DATE: Enter the date the authorization agreement is signed.

SIGNED: Signature of the employee authorizing the debit.

COMPANY NAME: Enter your company name.

RETURN FORMS: Retain one for your records. Give one to your bank. Send one back to Texas Certified Development Co.

ATTACH VOIDED CHECK: TEXAS CERTIFIED DEVELOPMENT CO., INC. P.O. BOX 6370 AUSTIN, TX 78762 AUTHORIZATION AGREEMENT FOR PRE-AUTHORIZATION PAYMENT (DEBIT)

I (we) authorize COLSON SERVICES CORP. (Company) to initiate debit entries payable to the account (described below) and bank (named below) to debit the amounts of such entries to the amount:

Periodically as such amounts become due, without further authorization (standing authorization).

Only on receipt of a further authorization signed by me (or either of us) authorizing a single entry in a specific amount (one-time authorization).

______Bank Name ______Address ______City State Zip

Account: Checking Savings Other: ______

Transit ABA Transit Routing Number Check Digit Account Number Information

Designated by Federal Reserve

NOTICE: When completing account number information, insert a hyphen (-) for each Dash Cue Symbol (-) contained in the field, and insert a number sign (#) for each “On Us” Cue Symbol I.

This form must be received by Colson Services Corp. prior to the 15th of the month for ACH changes/new accounts to be effective on the 1st of the subsequent month.

______Depositor(s) Name(s) ______Signature Date ______Signature 2 (As Required)

ATTACH VOIDED CHECK FOR CDC USE ONLY:

CDC Number: ______

SBA Loan Number: ______Borrower’s Name: ______