Common Contracts

ELECTRONIC FUNDS TRANSFER AUTHORIZATION AGREEMENT

Electronic Funds Transfer Authorization Agreement • February 19th, 2019

• Contract Type
  Electronic Funds Transfer Authorization Agreement
• Filed
  February 19th, 2019

VENDOR NAME (COMPANY NAME) VENDOR NUMBER (TO BE COMPLETED BY SCOTT & WHITE) ADDRESS CITY STATE ZIP ACCOUNTING/EFT CONTACT NAME TELEPHONE NUMBER FAX NUMBER IRS TAXPAYER ID (FEIN) EMAIL ADDRESS FOR REMITTANCEADVICE* (One email address only) FAX NUMBER FOR REMITTANCE ADVICE *