Last Updated: September 1, 2021

I acknowledge that by “Linking My Bank Account” I allow for funds to be transferred electronically via the Automated Clearing House (“ACH”) between my eligible Qoins (“Qoins Technologies Inc.”) account(s) and my external account(s) at other financial institutions (“External Account(s)”, once I have successfully registered my External Account(s). This includes:

• Monthly billing for its services/subscriptions. 
• One-time on-demand transfers, which allow me to initiate multiple, non-recurring, individual transfers based on the transfer date and dollar amount that I request through the “Transfer Funds” feature of Online and Mobile Banking from time to time;
• Recurring transfers, which allow me to initiate recurring transfers of a set dollar amount at regular intervals that I have established through the Transfer Funds feature of Online and Mobile Banking; and/or
• Other ACH transfer features that Qoins may make available.

Subject to the terms with Qoins and the terms of other agreements with Stripe & Plaid, I hereby authorize Qoins to initiate electronic credit/debit entries to my eligible “linked bank account(s)” and each registered External Account for (a) various amounts at varying times by making on-demand transfers pursuant to my instructions, and/or (b) fixed amount at the frequency I have selected by making recurring transfers pursuant to my instructions (a “Preauthorized Transfer”), and/or (c) fixed monthly subscription fee. If any transfer date falls on a weekend or bank holiday, I understand and agree that the transfer may be executed on the next business day, or as soon as reasonably possible at the discretion of Qoins.

I hereby represent and warrant that I have all necessary right, power and authority to debit and credit my Qoins account and any External Account(s) registered, and that all information or instructions that I provide to Qoins in relation to any ACH transfer is complete and accurate. I agree that ACH transactions I authorize comply with all applicable law.

Should an incorrect amount be withdrawn from or deposited to my External Account(s) or my Qoins account(s), I authorize Qoins to correct the error by debiting/crediting my External Account(s) or my “linked bank account(s)”.

This authorization is to remain in full force and effect until Qoins has received written notification from me of its cancellation/termination in such time and in such manner as to afford Qoins a reasonable opportunity to act on it. For Preauthorized Transfers, I understand that it is my responsibility to contact Qoins to stop or cancel a Preauthorized Transfer at least three (3) days prior to the following scheduled payment. In either case, I will send my notice to:

I acknowledge that the origination of ACH transactions must comply with the provisions of applicable law and the rules of the National Automated Clearing House Association (NACHA). I request the financial institution that holds my External Account(s) to honor all transfers initiated in accordance with this authorization form. 

I agree to print this ACH Authorization and retain a hard copy or save as an electronic copy.

Customer signature collected electronically.

© 2022 Qoins Technologies, Inc. All Rights Reserved

Qoins Card is issued by Evolve Bank & Trust, Member FDIC. Pursuant to a license from Visa U.S.A. Inc. Card is a prepaid debit card. Card can be used everywhere Visa debit cards are accepted. 

*Qoins deposits are insured up to $250,000 by Evolve Bank & Trust, Member FDIC.

Form C-AR