Royalty Agreement for Writers by zfs47164


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									                                                                     Direct Deposit Authorization Agreement
                                                                              for Royalty Payments

                                                PLEASE RETURN TO:
                          ASCAP Royalty Direct Deposit, One Lincoln Plaza, New York, NY 10023

Please indicate whether this is:                     Please specify to which account deposit is to be made:
   New Authorization                                    Checking Account - Business
   Change Authorization                                 Checking Account - Personal
                                                        Savings Account

Attach a voided check to this Authorization form (for checking account deposit). Must be a U. S. bank account.

routing number                                                              account number (input right to left)

bank name                                                                  ascap party name (successor, please enter your name)

account holder                                                             ascap party id

signature                                                                  date                               social security no./tax id. no.

By signing and submitting this form, you acknowledge that you have read and agree to the following Terms & Conditions:
I, the above-signed individual, authorize ASCAP to deposit electronically net royalty payments to the financial institution for which I have provided the bank account
information above. I understand that I will continue to receive copies of royalty statements by mail, but my checks will be directly deposited. If ASCAP erroneously
deposits money into this bank account, I authorize ASCAP to direct the financial institution handling this bank account, to debit that account and return the money. I
acknowledge that by receiving electronic deposits into this U.S. bank account, this bank as a financial institution must comply with any applicable provisions of U.S. law.
I understand that this authorization may take up to 14 days to go into effect and that once in effect, will remain in place for all ASCAP royalty distributions made after this
authorization until I have cancelled it in writing, by sending a letter signed by me to address listed above.

For faster enrollment, writers and publishers can sign-up online in Member Access at Successors must use this form.
If you have any questions, please call Member Services at 1-800-95ASCAP or email us at

                                                        Thank you for choosing Direct Deposit.
                                                                                                                                                                Ver: 10/05/09

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