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ADDITIONAL TERMS AND DISCLOSURES

CUSTOMER IDENTIFICATION PROGRAM NOTICE: In order to help the government fight the funding of terrorism,

money laundering activities, and identity theft, the USA PATRIOT Act requires all financial institutions to obtain, verify,

and record information that identifies each person who applies for a Bank Product. What that means to you is that

when you apply for a Bank Product through Republic, you will need to provide your name, street address, taxpayer

identification number, date of birth, and other information that will allow us to identify you including an unexpired,

government-issued, photo ID or other similar document.

7. EASY ADVANCE CERTIFICATIONS.

If this is an application for an Easy Advance, by signing this Application/Agreement, I (including my spouse if filing jointly) certify the following to be true: My expect e d

federal tax refund payment was not delayed by the IRS last year, nor was my federal tax refund fully or partially withheld by the IRS last year. I am not currently in

any dispute or audit with the IRS. I do not have a payment plan with the IRS. I do not have any outstanding tax liens. I have not previously filed a federal income

tax return this year (including any amended or prior year returns). I have not missed filing a required tax return in the last two (2) years. I am not delinquent in

student loan payments. I have not been incarcerated for six or more months during 2016 (includes work release and halfway house programs). I am not delinquent

in any child support or maintenance payments, VA or HUD loans, or any obligation involving a federal agency, including debts for food stamps. I do not currently

have a payment plan with any bankruptcy court. I have not filed for Chapter 7, 11 or 13 bankruptcy in the last two (2) years. I have not made an estimated tax

payment in 2016. I have not applied any of my 2015 federal tax refund to my 2016 taxes.

8. ACCEPTANCE OF EASY ADVANCE.

If this is an application for an Easy Advance, by signing this Application/Agreement, I understand that (i) the provision of Easy Advance proceeds to me constitutes

an offer by Republic to enter into a loan transaction with me and the terms of the proposed loan transaction are set forth in this Application/Agreement; (ii) My

negotiation of the Easy Advance Check (or other receipt of Easy Advance proceeds) shall constitute my acceptance of Republic’s offer, thus obligating me to

the terms of this Agreement; (iii) I may reject Republic’s offer by canceling the Easy Advance and declining to negotiate the Easy Advance Check or returning

the Easy Advance proceeds; (iv) Republic will make an Easy Advance to me if this Application is approved by Republic in its sole and absolute discretion; and

(v) I can only apply for an Easy Advance before February 28

, 2017. If I want to cancel the Easy Advance and decline to negotiate the Easy Advance check

or withdraw the Easy Advance proceeds, I shall notify Republic within 48 hours of the time I receive the Easy Advance check or proceeds of my intent to cancel

by contacting Republic at 1-866-581-1040. If I cancel the Easy Advance, I will promptly return the Easy Advance Check or proceeds to Republic. If I choose

to have my Easy Advance proceeds deposited into the Bank Account or any other account and choose to cancel the Easy Advance, I authorize Republic to

withdraw the proceeds. If I cancel the Easy Advance, Republic will disburse the amount of my tax refund, less the fees set out in Section 4 above.

9. SECURITY INTEREST IN REFUND.

I (including my spouse if filing jointly) hereby grant to Republic a security interest, and release any rights, in the anticipated tax refund to be paid to me by the

IRS and state taxing authority (if applicable) for the 2016 tax year and authorize Republic, at its discretion, to send or transmit my Easy Advance (if applicable)

or any amount due me, to me at my address or to my ERO for delivery to me and agree to hold Republic harmless if my ERO does not timely deliver the

check(s) to me.

10. ACCOUNT AND RELATED TRANSFER.

I authorize and request Republic to receive and process my federal and/or my state tax refund(s) by establishing an account for the sole purpose of receiving

my tax refund(s) and disbursing my Bank Product(s). No other deposits may be made to, and no withdrawals will be allowed from my account. Prior to disbursing

my Easy Advance, I authorize Republic to deduct the balance of the Easy Advance. Prior to disbursing my Refund Transfer, I authorize Republic to deduct

and pay any and all of the following fees and charges from my tax refund: (i) any current year outstanding balances and fees due Republic, including the

balance of my Easy Advance and/or Refund Transfer Fee(s); (ii) any or all authorized fees due the tax software company (Transmitter); (iii) any or all authorized

fees due my tax return preparer and electronic return originator (ERO); (iv) any or all authorized fees due my ERO’s service bureau; and (v) any outstanding

past due balance on any indebtedness of mine to Republic. I understand that the Fees set forth in Section 4 are not due until the Services are complete. The

Services are not complete until the earlier of (i) notification to me that the proceeds of my Refund Transfer are available or (ii) the 60

day after my tax return

has been e-filed with the IRS. The Refund Transfer will be disbursed to me by the method I selected in Section 3 above. If I chose Direct Deposit as my

disbursement method and the Bank Account information is incorrect or Republic is unable, for any reason, to honor my Direct Deposit request, my Refund

Transfer will be disbursed to me via check, printed by my tax preparer or mailed directly to me by Republic. If I chose Walmart Direct2Cash as my disbursement

method and I (i) do not pick up the Cash within fourteen (14) calendar days of notification from Republic that my Refund Transfer proceeds are available or (ii)

my Refund Transfer is more than $7,500.00 after all authorized fees are deducted, my Refund Transfer will be disbursed to me via check, printed by my tax

preparer or mailed directly to me by Republic.

11. AUTHORIZATIONS.

I (i) authorize Republic to inquire of the IRS, state taxing authority (if applicable), my employer or any agency providing information on behalf of my employer

as to the status of my tax refund(s) and as to my tax withholding and to receive from or supply to the IRS and the state taxing authority (if applicable) information

on my behalf; (ii) authorize Republic to investigate and verify from time to time all information provided to Republic; (iii) authorize Republic to verify my

employment and any of the information in this Agreement; (iv) authorize my ERO and Transmitter to provide to Republic, and authorize Republic to provide to

the IRS or other third parties as permitted by law, information obtained from my tax return, this Agreement, and other sources necessary to detect suspicious

or fraudulent tax returns and/or possible fraudulent Bank Products or for any other purpose permitted by law; (v) authorize Republic to use information I am

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Bank Product Application And Agreement (Application/agreement) - Louisville, Kentucky Page 2

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