Lockbox Service Acceptable Payees and
Accept All Payees Authorization and Indemnity
Client Target Date:
GFS Package #:
Implementation Advisor:
IA Phone #:
BANK USE ONLY
GCI Number:
Company Name:
Lockbox(es) #:
Lockbox Type:
Scannable
Image
Paper
Lockbox Location:
Atlanta
Boston
Los Angeles
St. Louis
Chicago
Dallas
Deposit Account #:
New Payee List (New Lockboxes only)
Change Existing Payee List (mark Add or Delete)
Replace Existing Payee List
*Note: The box name and account name are not automatically added as payee names.They must be listed to be included on the payee
list. If a closed box should be processed in an active box, their payees have to be added to the payee list.
Acceptable Payees (Acceptable Payee listing, the requirement that the acceptable payee be an affiliate).
Accept All Payees
Joint Payees
All Variations
*Note: Selecting "All Variations" allows payee names, which are on the client’s list to be accepted even when followed by descriptive
verbiage which includes, but is not limited to: Product, Services, Departments/Divisions.
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
Add
Add
Delete
Delete
*Note: 11+ Payees Incur Additional Charges.
Comments:
00-35-0124NSBW 09-22-2014 ST (SF)
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B a n k o f Am e r i c a - C o n f i d e n t i a l
© 2014 Bank of America Corporation
LOCKBOX SERVICE ACCEPTABLE PAYEES AND ACCEPT ALL PAYEES AUTHORIZATION AND INDEMNITY
Customer Warranties and Indemnities
If Customer is electing to add to, change, or replace the Acceptable Payee list, or if Customer is requesting Accept All
Payees, by the signature of its duly authorized representative below, Customer provides the following representations and
indemnities with respect to all items constituting third party checks and/or joint payee checks (wherein at least one payee is
not the Customer (the entity on the deposit account title:

Customer warrants and certifies that the non-Customer payees (“Third Parties”) on third party and/or joint payee
checks have authorized Customer to (i) deposit the checks into Customer’s account at Bank as Customer
designates on this form, (ii) commingle the check funds in Customer’s designated account, and (iii) retain the
deposited funds or draw checks or other withdrawals against the funds as determined by the Customer.

Customer warrants and certifies that Third Parties have authorized Customer to endorse, or authorize the
endorsement of Third Parties on these checks, if Third Parties’ endorsements are requested.

Customer agrees to notify Bank in advance, in writing, when it wishes to deposit checks into any other account(s) of
Customer at Bank, for which it has not previously obtained Bank’s agreement that such deposits may be made.
Bank may, in its sole discretion, approve or decline such future requests from Customer to add account(s).

Customer warrants that it shall cease to deposit checks or drafts payable to the Third Parties to its designated
account for any Third Party that does any of the following: files for protection in bankruptcy; becomes insolvent; is
the subject of a reorganization or other similar proceeding; or terminates, liquidates or dissolves its business or
disposes of a substantial portion of its assets.

Customer warrants that each check or other item deposited is not subject to a defense or claim in recoupment of
any party, which can be asserted against the Third Party or Customer.

Customer agrees to indemnify and hold harmless Bank and its officers, directors, affiliates, and employees
against all losses, claims, damages, liabilities, costs, judgments, awards, settlements, and expenses
(including but not limited to reasonable attorneys’ fees) which may be asserted against, or suffered by Bank
and/or any of its officers, directors, affiliates, and employees, as a result of Bank’s allowing Customer to: (i)
deposit checks to its designated account, with or without the endorsement or purported endorsement,
guaranteed or otherwise, of Third Parties of the checks, or (ii) commingle funds in its designated account.
Customer further agrees to refrain from asserting a claim against Bank and to hold Bank harmless for
permitting Customer to (i) commingle funds in its designated account; and (ii) deposit checks to its
designated account, with or without the endorsement or purported endorsement, guaranteed or otherwise,
of Third Parties.

The warranties and indemnities made by Customer herein will survive termination of the arrangements
described herein and/or closure of any and all of Customer’s account(s) with Bank.
Customer, by its signature, acknowledges that Bank is providing an accommodation to Customer, with respect to Third Party
check deposits as described above, that Bank is providing this accommodation in consideration of the warranties and
indemnities provided by Customer, that Bank may elect not to provide this accommodation, in whole or in part, at any time,
and that either Customer or Bank may terminate the arrangements described herein upon notice to the other party, provided
that the Customer’s warranties and indemnities will survive.
Customer Authorization
Print Name:
Signature:
Title:
00-35-0124NSBW 09-22-2014 ST (SF)
Phone #:
Extn.:
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B a n k o f Am e r i c a - C o n f i d e n t i a l
© 2014 Bank of America Corporation