B4L Fund Manager 25*

Has this client been issued funds before? *

Yes

No

Which form of delivery is the client requesting? *

ACH Transfer

Cash Pickup

Other

Employee Name *

First Name

Last Name

I, authorize this transaction to debit the Budz 4 Lyfe business checking account ending in 1276 in the amount requested previously. I understand that we cannot offer instant or direct payment methods as these may cause delays in fund release. *

Yes

No