I have read and agree to the terms of the BMO Express Loan Pay service provided to me and authorize BMO to deduct the amount indicated from my designated checking account to make a payment on my BMO Loan Account. The designated checking account, payment amount and BMO Loan Account are indicated on this Authorization.

I represent and warrant that I am at least 18 years of age and legally authorized to use the checking account designated on this Authorization.

Please print a copy and retain for your records.

Banking products are subject to approval and are provided in the United States by BMO Bank N.A. Member FDIC