Ngt Eft Authorization Form @

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Ngt Eft Authorization Form @

  1. 1. AUTHORIZATION AGREEMENT FOR AUTOMATIC PAYMENTS via Electronic Funds Transfer (EFT) or ACH Direct Deposit [AGENT AGREEMENTS] 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 Date: 01/14/2009 Signature: Title: Owner/Head Consultant FOR NGT USE ONLY Signed Document Received Date Prenote Date

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