Automatic Payment Account Change Agreement



Signature

_________________________________________________ _______________________________________________ ____________________

AUTOMATIC PAYMENT ACCOUNT CHANGE AGREEMENT

We’ve provided two agreements. Please read both pages of this Agreement, enter all the requested information, and sign both agreements.

Keep one for your records, and return the other agreement to us:

BY MAIL: CHASE AUTO, PO BOX 901063, FORT WORTH, TX 76101-2063

BY FAX: 1-800-255-9502

Page 1: Requested information

CHASE AUTO ACCOUNT INFORMATION

CUSTOMER NAME

CHASE AUTO ACCOUNT NUMBER

LAST FOUR DIGITS OF YOUR SOCIAL SECURITY

NUMBER

STREET ADDRESS

CITY

STATE

ZIP CODE

NEW DEPOSIT ACCOUNT INFORMATION

DEPOSIT ACCOUNT TYPE:

CHECKING (INCLUDE A VOIDED CHECK)



SAVINGS (INCLUDE A DEPOSIT SLIP)

FINANCIAL INSTITUTION ROUTING/ABA NUMBER

CHECKING/SAVINGS ACCOUNT NUMBER

FINANCIAL INSTITUTION NAME

FINANCIAL INSTITUTION STREET ADDRESS

CITY

STATE

ZIP CODE

AUTOMATIC PAYMENT AMOUNT AND WITHDRAWAL DATE

This request authorizes Chase to withdraw payments from your Bank account every month in the amount of the regularly scheduled payment, on the due date

specified in your Auto Account agreement (or other monthly amount or due date you agreed to with Chase), as described on Page 2 of this Agreement.

By signing below, you acknowledge that you have read this entire Agreement and that you agree to all the terms and conditions on both pages of the Agreement.

Deposit Account Holder’s Name Date

Customer Name (if different from Deposit Account Holder’s Name) Date

Page 2 - Automatic Payment Agreement - This form authorizes JPMorgan Chase Bank, N.A., its affiliates and its and their successors and assigns (including by

any servicing agent(s) of the of the account acting on their behalf) and any assignee of the account(s) to which this Agreement relates, (“Chase”) to set up

automatic payment withdrawal for your auto contract/loan or lease account (“Auto Account”) or to make a change to your existing automatic payment

Agreement. By signing this Agreement, you authorize Chase to make regular monthly deductions from the deposit account and financial institution (“Bank”)

you provided to us on Page 1 of this Agreement and apply them as payments to your Auto Account. This Agreement replaces any prior automatic payment

authorizations you may have provided. If this is a new authorization, keep making your monthly payments until the automatic payments begin. If this is a

change to an existing authorization, we will continue to draw on the existing authorization until the date we begin taking your monthly payment under

this authorization. We will send you a confirmation letter telling you the date we will begin taking your monthly payments.

For both loan and lease accounts: 1) The deductions we make from your Bank account will be applied as payments to your Auto Account each month in the

amount of the regularly scheduled payments and on the due date as specified in your Auto Account agreement or other due date agreed upon by you and

Chase. It typically takes about two business days for the funds to be deducted from your Bank account but your Bank could take longer to process the

withdrawal. 2) If a due date falls on the 29

, 30

, or 31

of a month and that date does not occur in that month, the due date will be adjusted to the last day

of that month. 3) If your due date falls on a weekend or a holiday, we’ll deduct your payment the next business day (Business days are Monday through Friday,

excluding federal holidays). 4) We won’t process your deduction if there’s nothing due on your account on the business day prior to your due date (for

example, if you already made the full payment some other way). 5) We may bill you separately for certain fees or charges on the Auto Account. 6) Your

account must be current to enroll in automatic payments.

Additional information for loan accounts: 1) If your deduction amount will vary as a result of other fees, charges or prepayment, we will notify you of the

revised amount typically by statement. The notice will provide the actual amount and the date of the deduction. 2) The monthly deduction amounts for some

accounts will not vary. If this applies to your account, you’ll stop receiving a monthly statement and each month’s deduction will be in the amount of the

monthly payment specified in your Auto Account agreement. 3) This Agreement will expire automatically one month prior to the last scheduled payment on

your loan account. We’ll send you a final bill with your last payment instructions and amount. The last payment will not be automatically withdrawn from

your Bank account.

Additional information for lease accounts: 1) We will deduct only the regularly scheduled monthly payment (that is, the monthly base payment and any

applicable sales/use taxes that are included as part of the total monthly payment due in that month). 2) If the applicable sales/use tax rate changes, we’ll

automatically adjust the amount of your payment and send you a notice prior to the change. 3) We won’t send you a paper statement once you sign up for

this automatic deduction. You can view electronic statements on chase.com. 4) This Agreement will automatically expire when we receive your last scheduled

payment on your lease account.

Returns: If your Bank sends us a returned payment for whatever reason, Chase may reverse the payment made to the Auto Account and you will be responsible

for any late fees, returned payment fees, and/or additional interest. If a deduction causes an overdraft of your Bank account, your Bank may assess an

overdraft fee or refuse to honor withdrawals. If your Bank returns more than one automatic payment, Chase has the right to terminate this Agreement and

future automatic payments. Failure to exercise this right is not a waiver of the ability to do so at a later time.

Cancellation/Termination: Chase can terminate this Agreement at any time with notice. You may cancel this authorization at any time by notifying Chase at

least three business days prior to the date that you’d like the cancellation to be effective. You can cancel by secure email message on chase.com or using the

payment page online; or by U.S. mail at Chase Auto, PO Box 901063, Fort Worth, TX 76101-2063. You can also call us to cancel or to ask questions at 1-800-

336-6675 for loan accounts or 1-800-227-5151 for lease accounts.

_________________________________________________ _______________________________________________ ____________________

AUTOMATIC PAYMENT ACCOUNT CHANGE AGREEMENT

We’ve provided two agreements. Please read both pages of this Agreement, enter all the requested information, and sign both agreements.

Keep one for your records, and return the other agreement to us:

BY MAIL: CHASE AUTO, PO BOX 901063, FORT WORTH, TX 76101-2063

BY FAX: 1-800-255-9502

Page 1: Requested information

CHASE AUTO ACCOUNT INFORMATION

CUSTOMER NAME

CHASE AUTO ACCOUNT NUMBER

LAST FOUR DIGITS OF YOUR SOCIAL SECURITY

NUMBER

STREET ADDRESS

CITY

STATE

ZIP CODE

NEW DEPOSIT ACCOUNT INFORMATION

DEPOSIT ACCOUNT TYPE:



CHECKING (INCLUDE A VOIDED CHECK)



SAVINGS (INCLUDE A DEPOSIT SLIP)

FINANCIAL INSTITUTION ROUTING/ABA NUMBER

CHECKING/SAVINGS ACCOUNT NUMBER

FINANCIAL INSTITUTION NAME

FINANCIAL INSTITUTION STREET ADDRESS

CITY

STATE

ZIP CODE

AUTOMATIC PAYMENT AMOUNT AND WITHDRAWAL DATE

This request authorizes Chase to withdraw payments from your Bank account every month in the amount of the regularly scheduled payment, on the due date

specified in your Auto Account agreement (or other monthly amount or due date you agreed to with Chase), as described on Page 2 of this Agreement.

By signing below, you acknowledge that you have read this entire Agreement and that you agree to all the terms and conditions on both pages of the Agreement.

Deposit Account Holder’s Name Signature Date

Customer Name (if different from Deposit Account Holder’s Name) Signature Date