Disclosure for Credits to a Loan at Other Financial Institutions

I (we) hereby authorize United Texas Credit Union, hereinafter called United Texas, to initiate credit entries to my loan account in the named depository institution, and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account. I also authorize the stated depository institution to accept and to credit and/or debit the same amount of such entries to my account.

This authority is to remain in full force until United Texas receives a completed termination request from me stating my intention to terminate this agreement. It is understood that United Texas must receive this termination request at least two weeks prior to the next pre-authorized credit transmittal date and in no event shall this termination request be effective with respect to entries processed by United Texas prior to receipt of the termination request.

Funds must be available for collection by United Texas at least two business days prior to the ACH credit. If the available balance at United Texas is less than the transaction amount, the item will not be processed. It is understood that United Texas will in no way be held liable for delinquent loan payments if the above stated terms have not been met.

The undersigned hereby agrees that these initiated entries are to be governed by the rules of the National Automated Clearing House Association and agrees to be bound thereby.

I understand United Texas will assess a fee as set forth in the Service Fee Schedule for each completed form and that incomplete forms will not be processed. The fee must be available in a United Texas Checking or Savings Account prior to the transaction.