Check Signature Request

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Check Signature Setup Request Form

Email:Enter the same email address which you signed in with:

Applicable Company Codes:For multiple companies, enter all company codes separated by a comma. IE. 9999, 9999A, 9999B

New Check Signature

Last four digits of the account number which the signature should be setup for:

Effective Check Date:

Set my existing check signature to print on manual checks

Last four digits of the account number which is used for printing manual checks:

Would you like to have the check signature printed on manual checks as well?Please note: Once the signature is set to print on manual checks, all users who have access to the ADS system will have the ability to print manual checks with signatures

YesNo

Please note: Once the signature is set to print on manual checks, all users who have access to the ADS system will have the ability to print manual checks with signatures.

Acknowledgment:

I acknowledge that all users who have access to the system will have the ability to print manual checks with signatures.

Acknowledgment:

I acknowledge that all users who have access to the system will have the ability to print manual checks with signatures.

Comments:

Complete and attach this Signature Form

File

UPLOAD SIGNATURE FILE

· I understand that it is the client’s responsibility to verify that all items were set up as requested, and it is the client’s responsibility to test the accuracy of the calculations resulting directly or indirectly from this request

· In no event will ADS be liable for any direct, indirect, incidental, consequential, punitive, or monetary damages, occurring as a result of this request, whether or not such damages were foreseeable and even if ADS was advised that such damages were likely or possible

Agreed