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You may need to contact your financial institution to verify if the deposit slip has appropriate routing numbers for direct deposit. Please mail the completed form to Kazdon Inc. P. O. Box 29927 Austin Texas 78755-6927 phone 512 345-0404 fax 512 340-0406 www. Section 125 Flexible Benefit Plan AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT New Direct Deposit Change Direct Deposit I hereby authorize Kazdon Inc* to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries made in error to my checking savings account check one indicated below and the depository named below hereinafter called DEPOSITORY to credit and/or debit the same to such account. Please Print Account Information DEPOSITORY/BANK NAME BRANCH CITY STATE TRANSIT / ABA ACCOUNT ZIP This authority is to remain in full force and effect until Kazdon Inc* has received written notification from me of its termination in such time and manner as to afford Kazdon Inc* and DEPOSITORY a reasonable opportunity to act upon it. EMPLOYER NAME Killeen Independent School District SOCIAL SECURITY NUMBER EMPLOYEE SIGNATURE DATE Attach void check / void savings deposit slip here NOTE A void check drawn on the checking account must accompany all applications for checking direct deposit. A void deposit slip for the savings account must accompany all applications for savings direct deposit. You may need to contact your financial institution to verify if the deposit slip has appropriate routing numbers for direct deposit. Please mail the completed form to Kazdon Inc* P. O. Box 29927 Austin Texas 78755-6927 phone 512 345-0404 fax 512 340-0406 www. Section 125 Flexible Benefit Plan AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT New Direct Deposit Change Direct Deposit I hereby authorize Kazdon Inc* to initiate credit entries and to initiate if necessary debit entries and adjustments for any credit entries made in error to my checking savings account check one indicated below and the depository named below hereinafter called DEPOSITORY to credit and/or debit the same to such account. Please Print Account Information DEPOSITORY/BANK NAME BRANCH CITY STATE TRANSIT / ABA ACCOUNT ZIP This authority is to remain in full force and effect until Kazdon Inc* has received written notification from me of its termination in such time and manner as to afford Kazdon Inc* and DEPOSITORY a reasonable opportunity to act upon it. Please Print Account Information DEPOSITORY/BANK NAME BRANCH CITY STATE TRANSIT / ABA ACCOUNT ZIP This authority is to remain in full force and effect until Kazdon Inc* has received written notification from me of its termination in such time and manner as to afford Kazdon Inc* and DEPOSITORY a reasonable opportunity to act upon it. EMPLOYER NAME Killeen Independent School District SOCIAL SECURITY NUMBER EMPLOYEE SIGNATURE DATE Attach void check / void savings deposit slip here NOTE A void check drawn on the checking account must accompany all applications for checking direct deposit.

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Keywords relevant to Kazdon Forms

  • notification
  • routing
  • depository
  • entries
  • Termination
  • ADJUSTMENTS
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