AUTHORIZATION AGREEMENT FOR AUTOMATIC PAYMENTS
via Electronic Funds Transfer (EFT) or ACH Direct Deposit
The company listed below, through its authorized representative (“Company”), hereby authorizes
New Global Telecom, Inc. (“NGT”), to initiate automatic payments (credit entries) to the account
indicated below at the depository financial institution named below (“DEPOSITORY”), in
accordance with applicable law.
This authorization shall remain in full force and effect until Company provides written notice to NGT
of the termination of this authorization, within reasonable time and to NGT’s notice address
provided in the contract between Company and NGT so as to afford NGT and DEPOSITORY a
reasonable opportunity to act on the termination.
Please complete the following:
Depository Name: Sovereign Bank Bank Branch: Pine Street
City: Harrisburg State: Pennsylvania
Routing Number: 231372691 Account Number: 0351061614
Account Type: X Checking Savings
The signature below of an authorized representative of Company provides NGT the authorization
necessary to directly deposit payments to Company, in accordance with the Agent Agreement
between Company and NGT.
Company Name (please print): Chris Young Consulting Company
Title: Owner/Head Consultant
FOR NGT USE ONLY
Signed Document Received Date