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STATE OF ALASKA

ZIP CODE + 4 ARE YOU ADDING,CHANGING (must provide PRIOR acct info)OR CANCELLING THIS AGREEMENT? *FINANCIAL INSTITUTION NAMEACCOUNT NAME (Business / Legal Name on Account)CheckingSavingsIS THIS ACCOUNT PRIMARILY A PERSONAL OR BUSINESS ACCOUNT? *PERSONAL- OR -BUSINESSFOR BUSINESS ACCOUNTS. Choose ONE of the business account addenda information format options *Indicates required ADDRESS for copies of remit advicePayments deposited separately with one addendum (remittance) record for each combined into one deposit with multiple addenda (remittance) records for each payment in the StateofAlaska sends a pre-note zero dollar test transactiontoverify the accuracyofthe banking information below. Paymentswillnotbesent electronically until the pre-note processis complete, generally five business days.

Payments combined into one deposit with multiple addenda (remittance) records for each payment in the deposit.

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