I/We hereby request TelPay e-Payment Services ("the Services") and authorize TelPay Inc. to debit payments authorized by me/us from my/our account(s). Notice of cancellation of this authorization may be made by me/us at any time. Such notice shall not have effect on debits made prior to cancellation. To make payments I/we will use the Affinity Credit Union Online Banking single sign-on connection to the Services. By deciding to make use of the Services, I/we accept that the required account information is automatically made available to TelPay for the purpose of processing payments. The authorization of TelPay Inc. to debit my/our account is subject to the TelPay Customer Agreement.

When using the Services, I/we will not be permitted to make payments from any account on which more than one signature is required to authorize a transaction, unless prior written authorization is received by Affinity Credit Union from all required signers.

Affinity Credit Union will establish service fees for use of the Services and/or for conducting transactions and may change these service fees from time to time. I/We authorize Affinity Credit Union to deduct any applicable service fees from any account.