ACD Online Contract Agreement

Name: Street Address: City: State: 27870: Email Address: Home Phone: Secondary Phone: Last 4 of Social Security Number: Driver's License Number: State Issued: I understand the following will be used to process my: Direct Deposit, Non-Disclosure Agreement, Independent Contractor Agreement, Statement of Work
I would like my funds to be deposited into a checking account or savings account (please notate in the field provided): Please provide the name and address of the bank: Please provide the Account Number: Please provide the Routing Number: I understand the terms of the Independent Contractor Agreement, Statement of Work and Non-Disclosure Agreement. I understand that I am the Authorized User and Exceptional Solutions LLC is the Support Company.
My printed first and last name will serve as my signature. Today’s Date Today’s Time