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Electronic Funds Transfer (EFT) Participant Setup FormBank of America / State of NCINSTRUCTIONS1. This Setup Form is to be completed by new participants in the EFT Master Services Agreement(MSA) (Contract No. ITS-007062) offered by the Office of the State Controller (OSC) and Bank ofAmerica. It provides information necessary for OSC staff, Department of State Treasurer (DST)staff, and Bank of America Treasury Services staff to establish the appropriate setups on varioussystems {ACH file transmission, Settlement bank account, Bank of America CashPro, billinginformation, statement rendering, etc}.2. In addition to the execution of this EFT Participant Setup Form, the participant must complete, orhave completed, an “Agency Participation Agreement (APA).3. From the OSC web site (EFT enrollment forms), click on the appropriate form to start the process offilling out the form online through DocuSign. Document flows have already been established andyou will receive a copy of the fully executed document at the end. You will also be able to check onthe status of your request (document) through DocuSign.Agency Contact Information4. If you have any questions, contact [email protected] .Participant InformationParticipant Name:Main Address:City:State:Zip:Name of Account:Note: This will be the second line of the account title.Agency Federal Tax ID:Fiscal Officer:Phone:Fax:Email ID:Alternate Contact Name:Title:Phone:Fax:E-mail ID:EFT Participant Setup Form1version 08-1-13

Participant Information – cont’dTechnical Contact Name:Title:Phone:Fax:E-mail ID:Type of ACH Files to be OriginatedSelect one of the following:Outbound ACH Credits (Vendor or Payroll);Inbound ACH Debits (Collections);Web Payments (Payments made via internet)Description of payments:Bank Settlement Account InformationProvide Wells Fargo EFT account number(s) being converted:Settlement Bank Account Number:Returns Account Number:Select and complete the item(s) that apply:Will use existing account(s):Settlement Bank Acct #:Returns Acct #:CB Template Number:(Completed by agency if using an existing template. Completed by DST if a new template is needed.)Request the establishment of a new settlement bank account for outbound ACH credit files.Note: Outbound ACH credit files for participants require a stand-alone DDA which must be funded timelyby the participant. Any returns will be credited to the account, which must then be cleared by theparticipant. The funding method depends upon the type of participant:* State agency participants will fund the account via wire transfer using DST’s Core Banking System(CB ) and must complete a CB Payment Preauthorization Form obtained from DST, which specifies thedisbursing/STIF account to be debited. Please request this form from DST if necessary.* Community Colleges and Local Education Authorities (LEAs) will fund the account according toinstructions in DST’s publication, Banking Services /BankingHandbook.pdf .See section entitled “Direct Deposit Guidelines for Community Colleges and LEAs.”New Account Number:(filled out by Bank of America)CB Template Number:(Completed by agency if using an existing template. Completed by DST if a new template is needed.)Request the establishment of a new settlement bank account for outbound ACH credit files and aReturns account.Note: Outbound ACH credit files for participants require a stand-alone DDA which must be funded timelyby the participant. The funding method depends upon the type of participant:EFT Participant Setup Formversion 08-1-132

Bank Settlement Account Information – cont’d* State agency participants will fund the accounts via wire transfer using DST’s Core Banking System(CB ) and must complete a CB Payment Preauthorization Form obtained from DST, which specifies thedisbursing/STIF account to be debited. Please request this form from DST if necessary.* Community Colleges and Local Education Authorities (LEAs) will fund the account according toinstructions in DST’s publication, Banking Services /BankingHandbook.pdf .See section entitled “Direct Deposit Guidelines for Community Colleges and LEAs.”Any returns will be credited to the returns account. The returns account for participants depositing withDST require a Zero Balance Account (ZBA), which sweeps nightly to DST’s bank account at Bank ofAmerica, DDA# XXXXXXXXXX063. The agency must submit one certification in CMCS for the totalamount swept each day. Specify the CMCS Group ID# to be certified under:Also, specify if either:a new CIT bank number (location code) is needed to be assigned by DST; oran existing location code will be utilized:New Account Number:New Return Account Number:(filled out by Bank of America)CB Template Number:(Completed by agency if using an existing template. Completed by DST if a new template is needed.)Request the establishment of a new settlement bank account for inbound ACH debit files.(State Agency participant only)Note: Inbound ACH debit files for participants depositing with DST require a Zero Balance Account (ZBA),which sweeps nightly to DST’s bank account at Bank of America, DDA# XXXXXXXXXX063. With thisoption returns will be debited from the settlement account. The agency must submit one certification inCMCS for the total amount swept each day. Specify the CMCS Group ID# to be certified under:Also, specify if either:a new CIT bank number (location code) is needed to be assigned by DST; oran existing location code will be utilized:New Account Number:(filled out by Bank of America)Request the establishment of a new settlement bank account for inbound ACH debit files.(Non-State agency participant only)Note: Inbound ACH debit files for participants not depositing with DST may use a ZBA settlement accountthat sweeps nightly to their local DDA. The ZBA to be established will sweep to acct #Alternately, the funds may settle directly to the participant’s existing local main DDA:New Account Number:(filled out by Bank of America)Request the establishment of a Returns account for inbound ACH debit files. State agencyparticipants should fund the account via wire transfer using DST’s CB . A Payment PreauthorizationForm may be obtained from DST to establish a template if applicable.Note: Inbound ACH debit transactions may occasionally “bounce” due to invalid account, Non-sufficientfunds (NSF), etc. Participant must reimburse the Returns account timely to clear any deficit balances.New Account Number:EFT Participant Setup Form(filled out by Bank of America)3version 08-1-13

Bank Settlement Account Information – cont’dCB Template Number:(completed by agency if using an existing template. Completed by DST if a new template is needed.)Other Request / Comment:Note: DST will notify the participant whenever the request has been acted upon.ACH File Transmission MethodFile transmission will be through (Select One of the following):The State’s Common Payment Service (CPS) gateway service (Arrangements must be made with CPS.)A third-party gateway service:(Must be pre-approved by OSC)A Value Added Network (VAN):(Bank of America will contract you for requirements)An FTP transmission directly to Bank of America. (Bank of America will contact you for requirementsand testing.)Other / Comment:ACH File Processing InformationThe following information is needed by Bank of America to be able to identify a valid ACH filereceived from the participant:1. Company Name:(Field length 16)This name must be the same as that contained in the ACH Batch Header Record, Field # 3.It will be displayed on the payee’s / payor’s bank statement, along with the “Company Discretionary Data”contained in Field #4 of the ACH Batch Header Record.Also, it is the Company Name used to set up users on Bank of America CashPro.2. Company ID:(Agency Federal Tax ID)This is the number that the settlement bank account will be associated with, as well as the number thatshould be contained in the ACH File Header Record, Field #4, with a prefix of 1.3. Estimated “Peak” dollar amount per file transmitted to the bank:This amount is used internally by Bank of America.4. Estimated daily (or weekly/monthly) amount per file transmitted to the bank:This amount is used internally by Bank of America.5. Please specify this is will be a daily, weekly or monthly file:6. Will the file processing include addenda records?If “yes” will Participant require a posting settlement file?YesYesNoNoIf “yes” you will be contacted by Bank of America Treasury Services Technical Support for additionalinformation.EFT Participant Setup Form4version 08-1-13

Payment of Fees ArrangementsSelect one of the following:Arrangements have previously been made with DST for the bank services fees to be paid by DST.(This is generally for payroll payments and NCAS related payments.) DST Signature:DST SignatureDateParticipant will pay for the bank services billed by Bank of America on a monthly basis. (Complete thesection below regarding the billing information.)The fee schedule may be viewed at the following site: http://www.osc.nc.gov/SECP/Fee Schedule.pdfBilling InformationComplete if bank service fees are to be paid by Participant (Select one of the following):Central Billing – Send invoices to the billing address associated with the Participant’s main DDAOrDecentralized Billing – Send invoices to the billing address belowParticipant Name:Main Address:City:State:Zip:Attention:Phone:Fax:Email ID:Statement Rendering InformationSelect one of the following:Central Reconcilement – Send monthly bank statements to the address associated with theParticipant’s main DDA (local units of govt. or community colleges). This option is not available to Stateagencies or universities.Decentralized Reconcilement – Send monthly bank statements to the address below:Participant Name:Main Address:City:State:Zip:Attention:EFT Participant Setup Form5version 08-1-13