Memorial’s Royalty Direct Deposit Enrollment Form
Memorial Production Operating LLC, a subsidiary of Memorial Production Partners LP, would like to take this opportunity to provide you with the optionto participate in our Royalty Direct Deposit program. This program is part of our continuing effort to provide the best customer service to our interest owners. Benefits of Royalty Direct Deposit include the elimination of mailing delays, lost or stolen checks and receipt delays related to address changes. Royalty Direct Deposit will allow an interest owner to receive an electronic funds transfer (EFT) at the financial institution (bank, credit union or savings and loan) of their choice. The EFT will deposit the monthly interest payment into the selected bank account and will be available for use the next business day following the check issue date. It is faster, convenient, more efficient, plus, it is free.In order to begin receiving Electronic Payments, please fill out the form below and attach a voided check.
If you choose to receive your payments electronically, your check detail will be available to view and print at on the check issue date. If you need Energylink support, please call 1-888-573-3364 or email support at energylink.com.
If you elect not to participate in our Royalty Direct Deposit program, simply disregard this letter and you will continue to receive payment by mail. No further action on your part is necessary.
The undersigned hereby agrees Memorial Production Operating LLC (Memorial)may reverse any electronic payment that is determined to be duplicate or made in error. Such interest owner further agrees that authorization of electronic funds transfer (EFT) as evidenced by the signature below amends the interest owner’s existing payment instructions to Memorial and such authorization will remain in effect until otherwise cancelled by the interest owner by way of written notification toMemorial. Interest owner may change any portion of the information provided below by giving at least thirty (30) days written notice. Interest owner agrees that Memorialwill not be liable for any interest or other claim arising as the result of interest owner’s failure to give such notice. Interest owner hereby agrees to the terms stipulated herein, certifying that the depository information listed below is accurate and authorizesMemorialto issue payments to interest owner electronically via EFT. Please allow up to two revenue cycles for this process to be completed.
Owner Number:______New Request_____Change Existing Set-Up
Account Name: ______
Address: ______Signature: ______
City, State, ZIP: ______Print Name: ______
Tax ID or Social Security Number: ______Title: ______
Account Type: ______Checking (VOIDED CHECK) (E.G., “Trustee” or “President”)
______Savings
Name of Bank: ______Daytime Phone Number:______
Bank Account Number: ______E-mail:______
Routing Number: ______Date:______
Please attach avoided check(checking account) or a letter from the bank verifying account and routing numbers.If you do not have either, please send a letter from the bank verifying your account information.Return the form and voided check to:
Memorial Production Partners
ATTN: LAND
500 Dallas St. Ste 1600
Houston, TX 77002
Fax: 713-583-9636
Email:
If you have any other questions or concerns, please contact the Royalty Hotline at 713-490-8951