Bank Draft Form (Page 3 of 3) in pdf

Bank Draft Form Page 3

Signature and Authorization

(You must sign this section for these changes to take effect.)

 I certify that all of the information provided by me on this form is true, complete and accurate.

 I certify that I have the authority to transact on the bank account listed by me in Section 4.

 I authorize the Mississippi Affordable College Savings Plan (MACS) to act on my instructions above, including to debit my bank account and to

deposit such funds into my Plan Account, or to cease such debits, as requested on this form.

 If I authorize contributions through the Automatic Contribution Plan (ACP) or the Electronic Purchase Option on this form, I also hereby

authorize the financial institution holding the bank account to process any such debits to my Account without responsibility for the accuracy of

the transaction. I further agree that neither MACS nor its agents or contractors will be liable for any loss, liability, cost or expense for acting

upon these instructions.

_______________________________

________________________________________________

____________

Signature of Account Owner, Custodian or Authorized Representative of an Individual or Entity

Date

Important Information

A Signature Validation Program Stamp is required for all entity Accounts and may be required for Accounts for which the individual completing this

form is acting in a legal capacity as a representative of the individual Account Owner. You may be required to provide proof of your authority to act

on behalf of this Account to your bank or broker before a signature validation stamp will be provided.

Note: The Signature Validation Program Stamp is not required if a MACS Power of Attorney Form is on file for an Individual Account, or if a MACS

Power of Attorney Form accompanies this form.

AFFIX STAMP HERE

Mail this form to:

Mississippi Affordable College Savings

P.O. Box 55037

Boston, MA 02205-5037

A13182

9/2014

Bank Draft Form Page 3