ACH DIRECT DEPOSIT AUTHORIZATION FORM

Payee Information (Recipient of Deposit)

Name(s):
Mailing Address:

Authorization

I/we hereby authorize C4 Mobile Gaming, LLC (“Company”) to initiate ACH Direct Deposit (credit) entries to the bank account identified below.
I/we also authorize the Company to initiate debit entries if a credit entry is made in error, in the amount of the original entry only.

This authorization will remain in effect until written notice of termination is provided by the Recipient and the Company has a reasonable opportunity to act upon it.

Bank Account Information

Bank Name:
Account Type: Type

Checking

Saving

Routing Number (9 digits):
Account Number:
Name on Account:

(Optional: attach a voided check or bank letter for verification.)

Payment Schedule

Purpose: Monthly lease payments under the “Game Truck Lease Agreement” effective December 1, 2025
Payment Schedule:
- $4,200 on January 1, 2026, February 1, 2026, and March 1, 2026
- $6,500 on the 1st day of each month from April 1, 2026 through November 1, 2027

If a payment date falls on a weekend or holiday, funds may be deposited on the next business day.

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