To make a Onetime Payment EFT complete the form below. Please allow up to 2 business days for processing your request. For Faster Processing, please login to your account and submit a payment before our 2:00 PM CST cutoff. I (we) hereby authorize Stonemark Holdings, Inc., hereinafter called Lender, to initiate debit entries to the checking/savings account, depository name (hereinafter called DEPOSITORY) below and to debit the said account.Form Completed By:*Agent / BrokerBorrower / InsuredSelect Bank Account to Debit:*Agent / BrokerBorrower / InsuredAccount Type*CheckingSavingsBank Name*Bank Routing Number (Please double check your entry to avoid possible return fees. It MUST be 9 digits.)*Bank Account Number (Please double check your entry to avoid possible return fees.)*Name on Bank Account*Borrower / Insured Name*Phone #*E-mail Address* Select one of the following:*Account # (begins with 1080)Account # (begins with 1070)Quote NumberAccount #*Account #*Account #Quote Number*Payment Amount*I (we) hereby authorize Stonemark Holdings, Inc., to use this information on this account as a payment and to use this information to make a onetime electronic funds transfer from my account or to process the payment as an electronic transaction. I am an authorized signer or authorized representative of the account, and have signed this sheet to certify this transaction.Electronic Signature of Authorized Signer on bank account* First Last Date: 01/21/2021