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, (Full name and surname in block letters) Identity number hereby request/instruct/authorise you to pay my benefits, if approved, into my undermentioned Bank/Building Society account. I understand that the credit transfers hereby authorized, will be processed by computer through a system known as ACB Magnetic Tape Service, and I also understand that no details of payment will be provided by my bank, but details of each payment will be printed on my bank statement. (This does.

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