Business Form Signature Card – Fill Out and Use This PDF

Check one of Signatures for New Account(s), Additional Signatures for Account(s) or Replace All Signatures on Account(s), and fill in Card __ of __.

The boxes under For BANK USE ONLY are This Signature Card is for a New Account and This is the first DDA for this client.

Write the Client Name/Account Holder; for a Sole Proprietor or Disregarded Entity, indicate the name of the owner.

Fill in the Account Title, the Address, City, State, Zip, the Account Number(s) and the Telephone Number.

Fill in the Tax ID Number; for a Sole Proprietor or Disregarded Entity, indicate TIN of owner.

Use BLACK OR BLUE ink. Place the Manual or Facsimile signature within the box boundaries only. Do Not overlap signatures.

Indicate if the signature is Manual or a Facsimile in the “PRINT NAME” box. When providing a Facsimile Signature, provide a Manual Signature too.

Each signature box has PRINT NAME, TITLE, SIGNATURE, Manual or Facsimile, E-MAIL ADDRESS and PHONE NUMBER.

For your security, cross out all unused signature boxes before signing the signature card.

The undersigned certifies that the (No.) signatures presented on these pages are the signatures of persons authorized to sign and otherwise act on behalf of the Account Holder with respect to its account(s), banking transactions or services. The undersigned, an authorized representative of the Account Holder, certifies that he/she has reviewed the information contained in this Signature Card, the Certificate Regarding Accounts, account authorization documents, and/or organizational documents of the Account Holder (“Authorized Documents”), and finds the information in this Signature Card accurate on this date and in accordance with the Authorization Documents.

The Bank is entitled to rely on the authority of the named person(s) until the Bank receives written revocation of such authority. No notice of revocation will be effective until the Bank has a reasonable opportunity to act on it.

The Business Signature Card is the form on which the undersigned is authorized to certify the names, titles, and signatures of authorized signers named in this Signature Card. The Account Holder acknowledges receipt of, and agrees to be bound by, the terms and conditions governing the operation of accounts and services provided by JPMorgan Chase Bank, National Association, (“the Bank”), including the Account Terms and Service Terms, as may be amended or supplemented from time to time.

The authorized representative of the Account Holder signs the Authorized Signature line, then fills in the Title and the Date.