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Get The Senior Alliance Vendor ACH Payment Authorization Form

Reement I (we) hereby authorize THE SENIOR ALLIANCE, hereinafter called COMPANY, to initiate credit entries to my (our) account listed below at the depository financial institution named below, hereafter called DEPOSITORY, and to credit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of the law. Select Type of Account: Checking Depository Name: Savings Depository Branch: City: State: Zip Code: Routi.

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