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Lish Electronic Funds Transfer (EFT) 2 AUTHORIZATION AGREEMENT FOR ELECTRONIC TAX PAYMENTS Change Contact Person Name, Business Name or Address Change Payment Method Taxpayer Business Name: Change Bank Information 3 Federal EIN: 4 Mailing Address for EFT purposes: C/O and Street Address or PO Box City 5 State ZIP Code Name and Telephone of Individual in your Organization that Revenue May Contact Regarding EFT: Last First M.I. Area Code, Telephone Number and Extension ( ).
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