WHAT YOU NEED TO KNOW BEFORE SELECTING A REFUND TRANSFER

REPUBLIC BANK & TRUST COMPANY

Tax Refund Options

Filing Method

Refund
Transfer

Disbursement Details

Estimated Issuance of
Refund

Bank
Fee

Paper Return

No

IRS Issued Check Sent U.S. Mail 1

6 to 8 weeks

None

Paper Return

No

IRS Direct Deposit to Your Account 1

6 to 8 weeks

None

E-File

No

IRS Issued Check Sent U.S. Mail 1

21 to 28 days

None

E-File

No

IRS Direct Deposit to Your Account 1

Within 21 days 2

None

E-File

Yes

Bank Direct Deposit to Your Account 1

Within 21 days 2

$17.95 3

Paper Return Options With No Additional Filing Costs: You have many options for filing your tax return and receiving
your refund, some of which have no additional filing costs. For no additional cost, you can mail your tax return to the IRS and
have your refund issued as a check sent in the U.S. mail or a direct deposit (if you have an existing account) within an
estimated 6 to 8 weeks after IRS acceptance.
E-File Options With No Additional Filing Costs: Also, for no additional cost, you can e-file your tax return to the IRS and
have your refund issued as a check sent in the U.S. mail in an estimated 21 to 28 days after IRS acceptance or by direct deposit
(if you have an existing account) usually within 21 days after IRS acceptance.
Refund Transfer: You may choose to receive your refund as a Refund Transfer which is a product provided by Republic Bank
& Trust Company. If you choose a Refund Transfer, your income tax return will be filed electronically and your refund will be
directly deposited in the bank account established for such receipt with your refund proceeds issued within an estimated 21
days after IRS acceptance. A Refund Transfer Fee and other authorized fees can be deducted from your refund amount and
forwarded to the appropriate party. The remainder of your refund will be direct deposited to your personal bank account. You
can choose a less expensive filing option that does not require the additional fees associated with a Refund Transfer.
A Refund Transfer is not necessary to obtain your refund.
A Refund Transfer is not necessary to obtain a direct deposit from the IRS if you have an existing bank account.
Withholding Change: Changing your income tax withholding might result in more income during the year rather than waiting
for an income tax refund.
Information About Opening a Low-Cost Bank Account: Go to www.joinbankon.org or www.eta-find.gov for information
about low-cost "starter" or "second chance" bank accounts and access to financial education resources.
1. It may take up to five additional days for your financial institution to post the refund to your account or for mail delivery.
2. Based on information published on www.irs.gov as of October 2012, the IRS issues over 90% of refunds within 21 days. Visit www.irs.gov for details
about your individual refund. Republic Bank & Trust Company does not guarantee whether, when or in what amount a tax refund will be issued.
3. The Refund Transfer Fee is charged for both state and federal tax refunds.

If you have any questions regarding the Refund Transfer, please visit
www.republictaxpayer.com or call 866-581-1040.

Refund Transfer Application and Agreement

Republic Bank & Trust Company, 601 West Market Street, Louisville, Kentucky, 40202
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 Refund Transfer. What that means to you is that when you apply for a
Refund Transfer through Republic Bank & Trust Company (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.
1. REFUND TRANSFER
I understand that by accepting this Refund Transfer Application and Agreement (Agreement), I am requesting and agreeing to
receive my federal or state tax refund, less the fees and payments set out in the Section 3 below, by direct deposit.
Republic will deposit my federal or state tax refund directly to my bank account (Bank Account). If the Bank Account
information is incorrect or Republic is unable, for any reason, to honor my direct deposit request, the Refund Transfer will
be disbursed to me via check, mailed directly to me by Republic.
Additionally, Republic reserves the right, in its sole and absolute judgment and discretion, to deny any Refund Transfer
Application and Agreement if the Internal Revenue Service (IRS) or applicable state taxing authority does not accept my
tax return for direct deposit into the Bank Account, or if I do not meet the Republic's eligibility criteria. If I am filing a joint
tax return, the pronouns I, me, and my used in this Application/Agreement shall be understood to include both the
applicant and the joint applicant and shall thus be read as we, us, and our, respectively, wherever applicable.
2. ACKNOWLEDGEMENT/CERTIFICATION/AGREEMENT
By accepting this Agreement in the spaces provided below, I do the following:
I acknowledge that I am at least eighteen (18) years old.
I acknowledge receiving a completed copy of this Agreement.
I acknowledge that I have received, read, and understand this Agreement, Republic's Privacy Notice, and a sheet
entitled What You Need to Know Before Selecting a Refund Transfer.
I acknowledge that the Refund Transfer is not a loan.
I certify that all my information contained in this Agreement is correct to the best of my knowledge, that this
Agreement is based on my 2012 federal and/or state income tax return(s) and that the tax return(s) are true,
complete, and accurate in all respects.
I agree to all the terms and provisions set forth in this Agreement, including the WAIVER OF JURY TRIAL AND
ARBITRATION section.
I irrevocably authorize Republic to deduct from my federal or state tax refund the amount of any outstanding debt
that I owe Republic.
3. FEES
Refund Transfer Fees
Refund Transfer Fee paid to Republic:
Total Refund Transfer Fees:

$ 17.95
$ 17.95

Tax Preparation Fees

Federal TaxACT Product Fee paid to TaxACT:
State TaxACT Product Fee Paid to TaxACT:
Data Archive Service (DAS) Fee paid to TaxACT:
Tax Audit Defense Fee Paid to TaxACT:
LegalACT Fee Paid to TaxACT:

$
$
$
$
$

12.95
0.00
0.00
0.00
0.00

Total Tax Preparation Fees:

12.95

TOTAL FEES WITHHELD FROM REFUND: $

30.90

4. ACCOUNT AND RELATED TRANSFER

I authorize and request Republic to receive and process my federal or my state tax refund by establishing an account for
the sole purpose of receiving my tax refund and disbursing my Refund Transfer. 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 Refund Transfer Fee; (ii) any or all authorized fees due the tax
software company (Transmitter); and (iii) any outstanding past due balance on any indebtedness of mine to Republic. The
Refund Transfer will be disbursed to me by direct deposit into the Bank Account.
5. 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 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 Refund Transfers or for any other purpose permitted by law; (v) authorize Republic to use information I am
providing to Republic in conjunction with this Agreement to verify my refund status with the IRS; (vi) authorize Republic to
change my Refund Transfer disbursement method at its discretion if necessary to process my Refund Transfer; (vii)
authorize Republic, if I provided my cellular phone number to my Transmitter, to send me text message alerts (message
and data rates may apply from my wireless carrier); and, (viii) authorize Republic, at its sole discretion, to send my Refund
Transfer, or any amount due me, to me at my address.
6. RELEASE OF MY REFUND TRANSFER INFORMATION
I authorize Republic to provide third parties, including without limitation, credit reporting agencies and Transmitter with
information regarding the status of my Refund Transfer, including whether the IRS or any state taxing authority funded,
partially funded or failed to fund my tax refund, and whether I obtained a Refund Transfer. (See Republic's Privacy Notice.)
7. ADDITIONAL TERMS
I authorize Republic to accept my federal tax refund from the IRS and/or my state tax refund from the applicable state taxing
authority and disburse the balance of my account to me by depositing it directly into the Bank Account. I understand
and agree that (i) Republic is not affiliated with and does not warrant the performance of the Transmitter or the
accuracy of the tax return; (ii) Republic's fees may be shared by Republic with the Transmitter; (iii) this Agreement is
governed by applicable federal laws and the laws of the Commonwealth of Kentucky; and (iv) Republic does not guarantee
whether, when, or in what amount, tax refund(s) will be issued.
8. REGULATORY DISCLOSURES
A. Federal Truth in Savings: When an account is opened for me, it is for the sole purpose of receiving my federal
tax refund from the IRS or my state tax refund from the applicable state taxing authority. No other deposits may be made
to, and no withdrawals will be allowed from my account. My account is non-interest-bearing and does not have any
minimum balance requirements. I will be charged the fees set out in Section 3 above.
B. Federal Electronic Fund Transfer Act: In the Case of Errors or Questions About My Electronic Transfers I will
telephone Republic at 1-866-581-1040 or write Republic at Tax Refund Solutions, P.O. Box 2348, Louisville, Kentucky 40201
as soon as I can if I believe my transaction history is wrong or I need more information about a particular transaction.
Republic must hear from me no later than sixty (60) days after I electronically accessed my account, if the error could be
viewed in my electronic history. I must tell Republic my name and Social Security Number, describe the error and explain
as clearly as I can why I believe it is an error and tell Republic the dollar amount of the suspected error. If I report an error
orally, Republic may require me to send my complaint or question in writing within ten (10) business days.
Republic will determine whether an error occurred within ten (10) business days after hearing from me and will correct any
error promptly. If Republic needs more time, however, it may take up to forty-five (45) days to investigate my complaint or
question. If Republic decides to do this, it will credit my account within ten (10) business days for the amount I think is in
error, so that I will have the use of the money during the time it takes Republic to complete its investigation. If Republic
asks me to put my complaint or question in writing and does not receive it within ten (10) business days, Republic may not
credit my account. For questions and errors involving new accounts, Republic may take up to ninety (90) days to investigate
my complaint or question. For new accounts, Republic may take up to twenty (20) business days to credit my account for
the amount I think is in error. Republic will tell me the results within three (3) business days after completing its
investigation. If Republic decides that there was no error, Republic will send me a written explanation. Copies of the

documents that Republic used in the investigation are available at my request.

Republic's business days are Monday through Friday, except for bank holidays.
Republic's Hours of Operation (all times listed are Eastern Time)
January 14th January 25th
Monday - Friday
9am - 9pm

January 26th February 16th

Monday - Friday
9am - 9pm
Saturday
9am - 5pm

February 18th March 1st

Monday - Friday
9am - 9pm

After March 1st

Monday - Friday

9am - 5pm

No other electronic fund transfers are allowed. Other than the Refund Transfer Fee described in Section 3, there is no
charge/fee for electronic fund transfer activity.
TRANSACTION HISTORY: I can access my transaction history by visiting www.republictaxpayer.com.
If Republic does not complete a transfer to or from my account on time or in the correct amount in accordance with
this Agreement, Republic will be liable for my losses or damages. However, there are some exceptions. Republic will not be
liable, for instance: (i) if, through no fault of Republic, I do not have enough money in my account to make the
transfer, (ii) if circumstances beyond Republic's control (such as a fire or flood) prevent the transfer despite reasonable
precautions that Republic may have taken, (iii) if the funds in my account have been offset by Republic in payment
of a delinquent loan, or (iv) if the funds have been attached or otherwise frozen as a result of a legal proceeding.
Republic will disclose information to third parties about my account or the transfers I make (i) when it is necessary
to complete transfers, (ii) in order to verify the existence and condition of my account for a third party, such as a
credit bureau or merchant, (iii) in order to comply with government agency or court orders, (iv) in accordance with
Republic's Privacy Notice, and (v) if I give Republic written permission.
C. Provisional Credit: Any credit given to me by Republic with respect to an automated clearing house (ACH) credit entry
is provisional until Republic receives final settlement for such entry. If Republic does not receive such final settlement, I
agree that Republic is entitled to a refund of the amount credited to me in connection with such entry, and the party
making the payment to me via such entry (i.e., the originator of the entry) shall not be deemed to have paid me in the
amount of such entry. Under the operating rules of the National Automated Clearing House Association, which are
applicable to ACH transactions involving my account, Republic is not required to give a notice to me of receipt of an
ACH item and will not do so. However, Republic will notify me of the receipt of payments in the transaction history, if any.
Any ACH transfer to or from the deposit will comply with U.S. law.
9. WAIVER OF JURY TRIAL AND ARBITRATION
A. Facts about Arbitration: Arbitration is a process in which persons or companies with a dispute: (i) waive their rights to
file a lawsuit and proceed in court and to have a jury trial to resolve their disputes; and (ii) agree, instead, to submit their
disputes to a neutral third person ( Arbitrator ) for a decision. Each party to the dispute has an opportunity to present some
evidence to the Arbitrator. Pre-arbitration discovery may be limited. Arbitration proceedings are private and less formal than
court trials. The Arbitrator will issue a final and binding decision resolving the dispute, which may be enforced as a court
judgment. A court rarely overturns an Arbitrators decision. THEREFORE, I ACKNOWLEDGE AND AGREE AS FOLLOWS:
B. Scope of Arbitration: The words "dispute" and "disputes" are given the broadest possible meaning and include, without
limitation all claims, rights and controversies arising from or relating directly or indirectly to (i) this Agreement (including this
arbitration provision and the fees charged), and any prior agreement or agreements between me and Republic, and any and
all aspects of my present or past relationship with Republic that relates to or concerns my tax refund, and, (ii) the signing
of this arbitration provision, including the validity and scope of this arbitration provision. Without limitation, the claims,

rights and controversies within the scope of the terms dispute or disputes includes any possible claims or rights that you
have against Republic or against any of Republic's employees, agents, officers, directors, managers, shareholders or affiliated
entities and/or Transmitter (hereinafter collectively referred to as related third parties), including those arising
under (i) federal or state law, including alleged violations of any state or federal constitution, statute or regulation and
common law theories such as those based upon contract, tort, fraud, or other intentional torts; (ii) any law or procedural
provision that otherwise might enable me to assert rights as a private attorney general, or as a representative and/or
member of a class of persons, or as a person acting in any other representative capacity (hereinafter referred to as
"Representative Claims"); and (iii) all claims arising from or relating directly or indirectly to the disclosure by Republic or
related third parties of any non-public personal information about me. The claims, rights and controversies within the scope
of the terms "dispute" or "disputes" also includes any possible claims or rights that Republic has against me, including all
counterclaims it may have in the event of a dispute that you raise.
C. Waiver of Jury Trial and Participation in Class Action: I acknowledge and agree that by entering into this arbitration
provision: (i) I AM GIVING UP MY RIGHT TO HAVE A TRIAL BY JURY TO RESOLVE ANY DISPUTE ALLEGED AGAINST
REPUBLIC OR RELATED THIRD PARTIES; (ii) I AM GIVING UP MY RIGHT TO HAVE A COURT, OTHER THAN A SMALL
CLAIMS TRIBUNAL, RESOLVE ANY DISPUTE ALLEGED AGAINST REPUBLIC OR RELATED THIRD PARTIES; AND (iii) I
AM GIVING UP MY RIGHT TO SERVE AS A REPRESENTATIVE, AS A PRIVATE ATTORNEY GENERAL, OR IN ANY
OTHER REPRESENTATIVE CAPACITY, AND/OR TO PARTICIPATE AS A MEMBER OF A CLASS OF CLAIMANTS, IN
ANY LAWSUIT FILED AGAINST REPUBLIC AND/OR RELATED THIRD PARTIES. Republic is giving up its rights to jury
trial and rights to have a dispute it has with you resolved in a court, other than a small claims tribunal.
D. No Class Arbitration: Except as provided in Paragraph H below, all disputes including any Representative Claims
against Republic and/or related third parties shall be resolved by binding arbitration only on an individual basis with me.
THEREFORE, THE ARBITRATOR SHALL NOT CONDUCT CLASS ARBITRATION; THAT IS, THE ARBITRATOR SHALL
NOT ALLOW ME TO SERVE AS A REPRESENTATIVE, AS A PRIVATE ATTORNEY GENERAL, OR IN ANY OTHER
REPRESENTATIVE CAPACITY FOR OTHERS IN THE ARBITRATION. THE ARBITRATION SHALL ONLY RESOLVE
MY RIGHTS, CLAIMS OR CONTROVERSIES, NOT THOSE OF ANY OTHER PERSON.
E. Arbitration Organizations and Procedures: Arbitration shall be commenced and conducted as follows:
Any party to a dispute, including related third parties, seeking to have that dispute resolved shall send the other party
written notice by certified mail return receipt requested of their intent to arbitrate and in that letter shall set forth the subject
of the dispute along with the relief requested. Regardless of who demands arbitration, I shall have the right to select the
entity that will administer the arbitration process from among: the American Arbitration Association (1-800-778-7879)
http://www.adr.org, JAMS (1-800-352-5267) http://www.jamsadr.com, or any arbitration organization that Republic may
designate in the event either AAA or JAMS or both are unable to act or do not honor (or are not expected to honor) the
terms of this Agreement. As an alternative, the parties may agree to select a local Arbitrator who is an attorney, retired
judge, or Arbitrator registered and in good standing with an arbitration association, to administer the arbitration. If I fail to
notify Republic of a selection for arbitration organization, within thirty (30) days of the demand for arbitration, then Republic
has the right to select the arbitration organization from the same list. The parties to such dispute will be governed by the
rules and procedures of such arbitration organization applicable to consumer disputes, to the extent those rules and
procedures do not contradict the express terms of this arbitration provision, including the limitations contained in this
Agreement. I understand that I may obtain a copy of the rules and procedures by contacting the arbitration organization
listed above. If the arbitration will be conducted by a local Arbitrator, the AAA rules in effect at the time this Agreement is
signed will govern (to the extent not inconsistent with this Agreement) unless the parties otherwise agree. If there is any
reason that an Arbitrator or arbitration organization cannot be selected under this paragraph, we agree that one will be
selected by a court, by consent of the parties, and the AAA rules in effect at the time this Agreement is signed will govern
the resulting arbitration (to the extent not inconsistent with this Agreement) unless the parties otherwise agree.
F. Payment of Arbitration Fees: Regardless of whom demands arbitration, upon my request Republic will advance my
portion of the expenses associated with the arbitration, including the filing, administrative, hearing and Arbitrator's fees
(Arbitration Fees). If the Arbitrator renders a decision or an award that provides material relief in my favor resolving the
dispute, then I will not be responsible for reimbursing Republic for my portion of the Arbitration Fees, and Republic will
reimburse me for any Arbitration Fees I have previously paid. If the Arbitrator does not render a decision or an award that
provides material relief in my favor resolving the dispute, then the Arbitrator may require me to reimburse Republic for the
Arbitration Fees it has advanced, not to exceed the amount which could have been assessed as court costs if the dispute had
been resolved by a state court with jurisdiction, less any Arbitration Fees I have previously paid.

G. Conduct of Arbitration: The arbitration hearing will be conducted in the county of my residence, or within 30 miles
from such county, or in the county in which the transaction under this Agreement occurred, or in such place as shall be
ordered by the Arbitrator. Throughout the arbitration, each party shall bear their own attorneys' fees and expenses, such as
witness and expert witness fees. The Arbitrator shall apply applicable substantive law consistent with the Federal Arbitration
Act, 9 U.S.C. Sections 1 - 16 (FAA); shall apply statutes of limitation; and shall honor claims of privilege recognized at law.
The Arbitrator may decide, with or without a hearing, any motion that is substantially similar to a motion to dismiss for
failure to state a claim or a motion for summary judgment. In conducting the arbitration proceeding, the Arbitrator shall not
apply any federal or state rules of civil procedure or evidence. If allowed by statute or applicable law, the Arbitrator may
award a party's reasonable attorneys' fees and expenses. At the timely request of any party, the Arbitrator shall provide a
written explanation for the award. The Arbitrator's award may be filed with any court having jurisdiction.
H. Small Claims Tribunal: All parties, including related third parties, shall retain the right to seek adjudication in a small
claims tribunal for disputes within the scope of such tribunal's jurisdiction. Any dispute which cannot be adjudicated within
the jurisdiction of a small claims tribunal shall be resolved by binding arbitration. Any appeal of a judgment from a small
claims tribunal shall be resolved by binding arbitration de novo, by a fresh review of the facts.
I. Governing Law: Our agreement to arbitrate is made pursuant to the FAA, because the transaction evidenced by this
Agreement may involve interstate commerce. If a final non-appealable judgment of a court having jurisdiction over this
transaction finds, for any reason, that the FAA does not apply to this transaction, then this agreement to arbitrate shall be
governed by the arbitration law of the Commonwealth of Kentucky.
J. Binding Effect: This arbitration provision is binding upon and benefits the parties to this Agreement and their respective
heirs, successors and assigns. This arbitration provision continues in full force and effect, even if my obligations have been
paid or discharged through bankruptcy. This arbitration provision survives any cancellation by prepayment, termination,
amendment, expiration or performance of any transaction between the parties and continues in full force and effect unless
the parties otherwise agree in writing. Republic may assign its rights to have disputes resolved by arbitration, either before
the dispute arises or thereafter.
10. CONSENT
By clicking "I ACCEPT" below, I certify that I have received a completed copy of this Agreement and further certify that I
have read, understand and agree to all the terms and provisions set forth in the DISCLOSURE AND CONSENT TO RECEIVE
DOCUMENTS ELECTRONICALLY, this Agreement, Republic's Privacy Notice, and the sheet entitled What You Need to
Know Before Selecting a Refund Transfer, and acknowledge receiving an electronic copy of each of them.

Rev 07/2010

FACTS
Why?

What?

WHAT DOES REPUBLIC BANCORP DO

WITH YOUR PERSONAL INFORMATION?
Financial companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell you how
we collect, share, and protect your personal information. Please read this notice carefully to
understand what we do.
The types of personal information we collect and share depend on the product or service you
have with us. This information can include:
Social Security number and payment history
transaction history and credit history
credit card or other debt and employment information
When you are no longer our customer, we continue to share your information as described in this
notice.

How?

All financial companies need to share customers personal information to run their everyday
business. In the section below, we list the reasons financial companies can share their
customers personal information; the reasons Republic Bancorp chooses to share; and whether
you can limit this sharing.
Does Republic Bancorp
share?

Can you limit this sharing?

For our everyday business purposes

such as to process your transactions, maintain
your account(s), respond to court orders and legal
investigations, or report to credit bureaus

Yes

No

For our marketing purposes

to offer our products and services to you

Yes

No

For joint marketing with other financial companies

No

We don't share

For our affiliates everyday business purposes

information about your transactions and experiences

Yes

No

For our affiliates everyday business purposes

information about your creditworthiness

No

We don't share

For nonaffiliates to market to you

No

We don't share

Reasons we can share your personal information

Questions?

Call 1-888-584-3600 or go to www.republicbank.com

Page 2
Who we are
Who is providing this notice?

Republic Bank & Trust Company and Republic Bank

What we do
How does Republic Bancorp protect my
personal information?

To protect your personal information from unauthorized access

and use, we use security measures that comply with federal law.
These measures include computer safeguards and secured files
and buildings.

How does Republic Bancorp collect my

personal information?

We collect your personal information, for example, when you

open an account or apply for a loan
use your credit or debit card or make deposits or withdrawals from
your account
provide employment information
We also collect your personal information from others, such as credit
bureaus, affiliates, or other companies.

Why cant I limit all sharing?

Federal law gives you the right to limit only

sharing for affiliates everyday business purposesinformation
about your creditworthiness
affiliates from using your information to market to you
sharing for nonaffiliates to market to you
State laws and individual companies may give you additional rights to
limit sharing.

Definitions
Affiliates

Companies related by common ownership or control. They can be

financial and nonfinancial companies.
Our affiliates include companies with a common corporate identity of
Republic Bancorp

Nonaffiliates

Companies not related by common ownership or control. They can be

financial and nonfinancial companies.
Republic Bancorp does not share with non-affiliates so they can
market to you

Joint marketing

A formal agreement between nonaffiliated financial companies that

together market financial products or services to you.
Republic Bancorp doesnt jointly market