Customer: *

First Name

Last Name

Phone *

(###)

###

####

Type *

Checking

Savings

Frequency *

One Time

Recurring Monthly

Process Date

MM

DD

YYYY

Disclaimer (Please Read) *

First National Bank of Livingston Transfer Agreement:

Customer Account: Pebble Creek Investments, LLC : These accounts remain subject to their individual terms and conditions, which are not modified by this agreement. If a transfer is made from a savings account, we reserve the right to require not less than 7 days written notice of withdrawal. For Recurring payments, If no termination date is specified , this agreement will remain in effect until terminated by anyone of us. It is understood that at any time the transfer is to be made and there are not sufficient funds in the account to process the transfer, we have the right to cancel this agreement. You May terminate this agreement by giving us 15 days written notice in person, or by mail to P.O. Box 671 Livingston, TX 77351.

I have read and agree to the Transfer Agreement

Electronic Signature Authorization: *

By inputting your Electronic Signature below, you authorize us to transfer funds as indicated above and you agree to all terms and conditions to this Agreement

I have read and consent to Electronic Signature Authorization