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Direct Deposit Authorization Form

BANK ACCOUNT INFORMATION
Type of Account:
Checking
Savings
Payment Type
Dollar Amount ($)
Percentage (%)
Entire Paycheck

Attach a voided check for each account to which funds should be deposited, if required. By signing below, I authorize Reward Home Care to initiate direct deposit entries to the account(s) listed above and to make any necessary corrections or adjustments. This authorization will remain in effect until I modify or cancel it in writing with reasonable advance notice to allow processing time. 

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