New form

HLC-B CARRIER PAYMENT OPTION FORM

EMAIL: AUDREY@HLC-B.COM

Telephone: 918.649.7796

HESTER LOGISTICS CONSULTING & BROKERAGE

TIA CERTIFIED TRANSPORTATION BROKER

BROKER MC#: 1534754 USDOT: 4050532

FEDERAL TAX ID/EIN: 88-0955040 D-U-N-S #: 06-321-6676

SAME DAY (4% FEE ACH MUST SUBMITTED BEFORE NOON) OR NEXT DAY (3% FEE ACH MUST BE SUBMITTED BEFORE NOON) QUICK PAY AVAILABLE VIA ACH OR ZELLE

DO YOU WANT QUICK PAY?

YES

IF YES, CHOOSE THE CORRECT OPTION BELOW.

ACH SAME DAY MUST BE SUBMITTED BY NOON. ZELLE SAME DAY MUST BE SUBMITTED BY 3PM ACH NEXT DAY MUST BE SUBMITTED BY NOON ZELLE NEXT DAY MUST BE SUBMITTED BY 3PM

BANK/FINANCIAL INSTITUTION NAME

ROUTING #:

ACCOUNT #:

ZELLE BUSINESS OR INDIVIDUAL NAME:

ZELLE PHONE NUMBER OR EMAIL ASSOCIATED WITH THE ACCOUNT:

STANDARD PAY OPTIONS

NET 28 DAYS OR LESS VIA ACH NET 28 DAYS OR LESS VIA ZELLE NET 28 DAYS OR LESS MAILED CHECK

MAIL CHECKS TO ADDRESS OR EMAIL ADDRESS FOR REMITTANCE:

Your information will be encrypted.