ENROLLMENT FORM FOR

ELECTRONIC PAYMENT TRADING PARTNER

All remittance information will be supplied to each vendor via the Vendor Net
WWW.Brinker.com/vendors

BRINKER INTERNATIONAL

Vendor Number:

Company Name:
Address:
Contact Name:
Phone:
Email:
IRS Taxpayer ID#:
Bank Name:
Address:
Contact:
Phone:
ABA:	Routing or Transit Number: (located on the bottom of your checks)
Account #:
Name on Account:
Account Type (Checking or Savings):

PLEASE READ THE ATTACHED TERMS AND CONDITIONS FOR ELECTRONIC PAYMENT. If you do not understand or agree with any terms and conditions therein stated do not sign and return this Enrollment Form to Brinker. Your signature below indicates you have read, understand, accept and agree to abide by the terms and conditions.

Name (print): ___________________________ Signature: ____________________

Title: ________________________________ Date: ________________________

Return to Brinker International  6730 LBJ Freeway  Dallas TX 75240
Fax # 972.628.8479

Terms and Conditions for Electronic Payment

All remittance information will be supplied to each vendor via the Vendor Net
WWW.Brinker.com/vendors

1. Brinker will rely exclusively on the information supplied on the above enrollment form in connection with the payment of funds via Electronic Payment.

2. The electronic funds transfer will be made to the financial institution and account number on this enrollment form. Please verify that you supplied the correct information.

3. Payments will be made by our bank in accordance with the National Automated Clearinghouse Association’s Corporation Trade Payments Rules. Our process is governed by the laws of the State of Texas.

4. The information you provide on the form is very important. You are responsible for communicating any and all changes in the information on the Enrollment Form. All changes must be made by an authorized representative of your Company in writing and allowing sufficient time for Brinker to respond to the change. You will indemnify and hold harmless Brinker for any loss arising by reason of error, mistake or fraud regarding this information.

5. Payment is initiated within the normal terms of our commercial agreement with you. These terms and conditions neither enlarge nor diminish the respective rights and obligations of Brinker within any applicable commercial agreement. The payment due date is not affected. We will consider payment made when your financial institution has received or has control of the payment transaction. This settlement date generally occurs within three (3) banking days following initiation by Brinker.

6. Brinker has the right to adjust future payments if payments previously made are found to be duplicate, in excess of requirements, fraudulent or in error.

7. Brinker is not responsible beyond the point where your financial institution receives or has control of the transaction. Any loss of data at that point will be borne by you unless the loss is solely due to negligence by Brinker or its originating bank. You should notify Brinker immediately if payment is not received as described in Item 5 (above). Brinker will have a reasonable time (not to exceed ten (10) business days) to trace said payment.

8. You may terminate receiving payment via Electronic Funds Transfers provided Brinker receives notification in writing, and the termination date is, at least, twenty (20) business days after the written notification is received by Brinker. Brinker may terminate the use of Electronic Funds Transfers from time to time and at any time.

9. All notices to you shall be sent to the address provided on the Enrollment form. All notices to Brinker shall be sent to EFT Disbursements Manager, Brinker International, 6820 LBJ Freeway, Dallas, Texas 75240.