The below named individual hereinafter referred to as “Client” requests The National Association of Public Employees, LLC. hereinafter referred to as “NAPE”, to provide the
services described below, under the terms and conditions outlined in the Agreement, in return for a periodic service fee identified above and agreed hereto.

SERVICES
The Client shall receive the following services from NAPE: Effectuate the payment of monies, including premium(s) or deposits to designated third parties as requested or otherwise
directed in writing by Client. In exchange for providing the monthly services for Client, NAPE is entitled to a monthly service fee as designated above. The fee is earned following
the performance of the monthly service and is not refundable. NAPE may, from time to time, in its discretion modify the service fee upon thirty (30) day written notice to Client.
In order to receive the above services, Client hereby authorizes their bank to accept periodic electronic transfers or drafts from the Bank’s Automated Payment Service for the amount
stipulated above or as modified in writing from Client in the frequency stipulated above. Said transfers shall continue subject to the terms of the Agreement.
AUTHORIZATION FOR AUTOMATIC TRANSFER OF FUNDS: (NOT APPLICABLE TO ANNUAL PAYMENT)

I/we hereby authorize the transfer of funds held in the above named institution for the purpose of making monthly payments on my behalf. I authorize the above named institution to
accept transfer of funds as if the transfer were signed personally by me. This authority is to remain in effect until I revoke same in writing, and I agree that each institution involved in
any transfer shall be fully protected in honoring such transfers until such time. I further agree that if any transfer is dishonored due to any reason, the institutions involved shall be
under no liability whatsoever even though it may result in the non-payment of my monthly membership fee. In addition, I authorize NAPE to reverse any payment made on my behalf
if my transfer is dishonored for any reason. In the event that an erroneous electronic transaction is posted to my account, NAPE may execute a reversal of that transaction. My
personal check payment may be converted to an electronic payment processed through the Automated Clearing House Network (ACH). My payment will be reflected on my financial
institution’s monthly account statement as an electronic payment in the amount of my check, and will reference the check number I use to make this payment. For further information
or to opt-out of the electronic check program, I understand that I must call (877-462-8622) during regular business hours.
I authorize ACH payment of initial premium in lieu of personal check or credit card if not included with my application.

TERMS AND CONDITIONS
Client may terminate this Agreement at any time giving NAPE thirty (30) days written notice. NAPE may choose to terminate this Agreement if for any reason a debit transfer from
Client’s bank cannot be made. In the event of an EFT or credit card charge that is not honored by the client’s bank for any reason, a service charge will be imposed on the client. The
amount of the service charge will be the standard fee then in effect, which is subject to modification by NAPE from time to time in its sole discretion. Client acknowledges that, in the
event a debit transfer is unsuccessful for the reasons stated above, any payments on the Client’s behalf to any institution will not be made until Client satisfies the unsuccessful debit
plus all related fees. Should NAPE choose to terminate this Agreement due to occurrence of unsuccessful debit transfer, the Client will forfeit any right to a refund of any fees paid to
date, without release of obligation on monies still owing to NAPE, or its custodian.
I/we have read, and agree to, the terms and conditions as stated above.
Client agrees that any monies owed to NAPE, or its custodian, shall be subject to any additional charges and costs incurred by NAPE, or its custodian, through collection procedures,
legal fees, and court costs. In the event that the parties must litigate disagreements arising from this contract, the parties hereto agree to conduct any such litigation under the laws of
the State of Mississippi, and that venue for such proceedings shall be only in the County of Madison, State of Mississippi. Client agrees that any late fees, adverse credit reports to any
credit reporting agency, loss of coverage, or loss of interest/gain on any capital accumulation account due to inaccessible or insufficient funds in the Client’s account are the sole
responsibility of the Client. Client agrees that NAPE, the custodian, and all recipients of directed payments shall not be liable for any loss occasioned by inadvertent delay or error in
remitting monies to the institution or designated account, nor shall such companies bear any responsibility for any security transactions effectuated on behalf of Client by a third party.

IT IS THE CLIENT’S RESPONSIBILITY TO NOTIFY NAPE IN WRITING, THIRTY (30) DAYS PRIOR TO THEIR NEXT PAYMENT OF ANY CHANGE OF
ADDRESS, BANK ACCOUNT NUMBER, CHANGE OF BANK, PAYMENT AMOUNT, OR PAYMENT METHOD. FAILURE TO DO SO MAY RESULT IN A
TERMINATION OF YOUR ASSOCIATION MEMBERSHIP.

If any one or more of the provisions and/or conditions contained in this Agreement shall be held invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or
unenforceability shall not effect any other provision of this Agreement. This is the parties’ entire agreement as pertains to this Service Agreement, superseding all previous oral or
written agreements, representations, or express or implied warranties.