PAYMATICS SET-UP/CHANGE AGREEMENT ®

PAYMATICS® SET-UP/CHANGE AGREEMENT
This form authorizes Chase to set up Paymatics (automatic payment withdrawal) for your auto loan or lease account or make a change to your existing Paymatics
Agreement with Chase. Paymatics automatically deducts your payments directly from your checking or savings account on your payment due date each month.
To process your authorization, please read the Automatic Payment Agreement below, complete this form and return it by mail or fax:
Mail: Chase auto FinanCe, Po Box 9160, Garden City, ny 11530-9160
Fax: 1-800-759-5069
Note: If you are setting up automatic payments from your checking account, please include a voided check.
ChAse AuTo FINANCe ACCouNT INFormATIoN
CusTomer NAme
ChAse AuTo FiNANCe ACCouNT Number
LAsT Four digiTs oF your
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 NeW AuTomATiC PAymeNT sigN uP
ZiP Code
 ChANge dePosiT ACCouNT iNFormATioN
DePosIT ACCouNT INFormATIoN
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 CheCkiNg (iNCLude A voided CheCk)
FiNANCiAL iNsTiTuTioN rouTiNg/AbA Number
 sAviNgs
CheCkiNg/sAviNgs ACCouNT Number
FiNANCiAL iNsTiTuTioN sTreeT Address
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By signing below, you acknowledge that you have read this entire agreement and that you agree to all the terms and conditions of the agreement.
Deposit Account Holder’s Name
Secondary Deposit Account Holder’s Name (if required)
Signature
Date
Signature
Date
Automatic Payment Agreement
By signing this Agreement, you authorize JPMorgan Chase Bank, N.A. (“Chase”) to make regular deductions from the deposit account and financial institution indicated above and apply them to your Auto Contract, Loan or Lease Account
(“Auto Finance Account”) as automatic payments.
We will apply the checking or savings account deductions referred to in this Agreement, as monthly payments to your Auto Finance Account in the amount of the regularly scheduled payments and on the due dates specified in your Auto
Finance Account agreement. If a payment due date falls on a weekend or holiday, the deduction will occur on the next business day. A “business day” means Monday through Friday, excluding federal holidays. If a due date falls on the 29th,
30th or 31st of a month and that date does not occur in that month, the deduction will occur on the last day of that month.
Account Specific Deduction Information
For loan accounts we will:
•Deduct your scheduled payments from the checking or savings account you have indicated on the due date each period.
•Notify you of the revised scheduled payment amount via a paper or electronic statement, if your scheduled payment amount varies as a result of other fees, charges or prepayment. We will show the actual amount of the deduction for
the scheduled payment on your statement.
If you obtained your vehicle loan through a dealer, you may no longer receive a statement.
This Agreement will expire automatically one month prior to the last scheduled payment on your loan account.
YOU ARE RESPONSIBLE FOR MAKING THE LAST PAYMENT ON YOUR LOAN ACCOUNT. WE WILL NOT AUTOMATICALLY WITHDRAW THE LAST
PAYMENT FROM YOUR BANK ACCOUNT. We will send a final bill to you with last payment instructions and amount.
For lease accounts we will:
•Deduct only the regularly scheduled monthly payment (that is, the monthly base payment, any applicable sales/use taxes that are included as part of the total monthly payment due in that month).
•Adjust the amount debited from your bank account to correspond to periodic changes in any applicable sales/use taxes included as a part of the regularly scheduled monthly payment due under the terms of your Auto Finance Account
agreement.
•Not send you a paper statement once you sign up for this automatic deduction. You can view electronic statements on Chase.com.
This Agreement will expire automatically upon receipt of the last scheduled payment on your lease account.
For all Auto Finance Accounts we will:
•Bill you separately for any other fees on the Auto Finance Account.
•Not automatically withdraw a payment for the current month, if you make a large enough prepayment that is applied to the Auto Finance Account through another payment method, which would cause the due date to change to the
next month.
If your financial institution returns more than one automatic payment for the Auto Finance Account, 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. Chase reserves the right to reverse any credits made to the Auto Finance Account if the financial institution returns the automatic payment. If the financial institution does not honor the payment, you will be responsible for
any late fees, returned payment fees, and/or additional interest on the Auto Finance Account. If an automatic deduction causes an overdraft of the deposit account at the financial institution, this may result in the financial institution assessing
an overdraft fee, or its refusal to honor withdrawals.
Cancellation
This Agreement replaces any prior payment authorizations you may have provided. You may cancel this authorization at any time by notifying Chase at least three business days prior to the date that you would like the cancellation to be
effective. You can cancel by phone at 1-800-336-6675 for loan accounts or 1-800-227-5151 for lease accounts Monday through Friday from 8 a.m. to 10 p.m. Eastern Time or Saturday from 9 a.m. to 5:30 p.m. Eastern Time; by secure email
request on Chase.com; or by U.S. Mail at Chase Auto Finance, Attn: Research Dept, PO Box 901076, Fort Worth TX 76101.
If you have any questions, please call 1-800-336-6675 for loan accounts or 1-800-227-5151 for lease accounts Monday through Friday from 8 a.m. to 10 p.m. Eastern Time or Saturday from 9 a.m. to 5:30 p.m. Eastern Time.
Please continue to make your scheduled monthly Payments until you receive a confirmation letter with your Paymatics (automatic Payment) start date. keeP a coPy of this
agreement for your records.
© 2013 JPMorgan Chase Bank, N.A. Member FDIC. All rights reserved. (13-145) 04/13
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