Renter Box No Deputy Rental Deputy Due In
Renter ____________________________________ Box No. _________ Deputy ___________________________________ Rental _________ Deputy ___________________________________ Due In _________ SIGNATURE AND RECEIPT OF RENTER In the Vaults of I have this day rented Safe Deposit Box No. _________ subject to the rules and conditions listed below and/or those posted in the Safe Deposit area of this institution. I hereby consent and agree to these rules and conditions. I have also received _____ keys to said box. I further agree to pay for the use of this box annually in advance, the rental specified hereon, until I have returned the keys to said institution. In event of losing the keys, I agree to pay the expense of replacing the keys and any repairs necessitated by forceful opening of the Safe Deposit Door. SAFETY DEPOSIT BOX RENTAL RULES AND CONDITIONS 1. It is one of the conditions of the renting of said box that said institution shall in no event be liable for any loss from such box, through negligence, for an amount in excess of three hundred times the agreed annual rental. 2. That said institution shall in no event be liable for any loss of money, jewelry, or bearer securities placed in said box. 3. That evidence tending to prove that securities, money, valuables or other articles were left in said box, upon the last entry by the lessee or 4. 5. 6. 7. customer or his authorized agent, and that the same were found missing upon a subsequent entry, shall not be sufficient to to raise a presumption that the same were lost by any negligence or wrong doing for which said institution is responsible or put upon said institution the burden of proof that such alleged loss was not the fault of said institution. The lessee stipulates that he has examined the location of the box and accepts same and the location thereof as safe. It is further stipulated that the rental reserve is for annual rent payable in advance annually. In the event the lessee shall not pay the rent promptly when due, such lease shall be regarded as terminated and said institution may remove the contents of such box and shall be liable for no loss of any of the contents of the same whatsoever occurring during any time the lessee shall be in arrears on his payments for the annual rental reserve or any part thereof. In the event the lessee shall fail to pay when due the annual AMOUNT DATE PAID TO PAID rent reserve, then in addition to other remedies, the said institution may upon 30 days elapsing without the said rent being paid, enter said box and take out the contents thereof, and sell the same at public auction at said institution, by giving 20 days’ notice thereof by posting in the lobby of said institution and by mailing to the last address of the lessee known to the president of said institution, selling said contents of said box and after the rental charges and any other claims or charges the said institution may have against the lessee have been paid by retaining by said institution from the proceeds of said sale if had, if sufficient to re-pay the same, and the balance, if any, shall be paid to the lessee or any other person legally entitled thereto. I have read the foregoing and the matters printed hereon and agree to the same. _________________________________________________________________________ Signature of Renter _____________________________________ Address _____________________________________ Witness E. GREENE & COMPANY • FAIRFIELD, NJ 07007 • 877 -838 -5250 • Access Card # 949
APPOINTMENT OF DEPUTY __________________________________, 20_______ I hereby designate ______________________________________________________________________________________ as my deputy, to have access to and control of the contents of my Safe Deposit Box now rented, or which may hereafter be rented by me, until this authority is revoked by me in writing. _____________________________________________________________ Signature of Agent Signature of Renter REVOCATION OF APPOINTMENT __________________________________________________, 20_______ I hereby revoke my order appointing ____________________________________________________________________________________________________ as my deputy. _____________________________________________________________ Signature of Agent Signature of Renter REMARKS RELEASE Debit Authorization I / We hereby authorize the Credit Union to charge our account number ____________ for the annual safe deposit box rent. _________________________ Signature of Renter Date _________________________ Signature of Renter _____ Keys returned ____________________, 20_______ I hereby certify that all the papers and other property placed within my Deposit Box, in pursuance of the contract above cited have been duly and properly withdrawn therefrom and are in the owner’s full possession, and said institution discharged from all liability in respect thereto. Date _________________________________________________ Signature of Renter Access Card 949 -2
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