AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTSAuthorization Agreement for Direct Payments • April 27th, 2011
Contract Type FiledApril 27th, 2011THIS FORM MAY BE REVOKED ONLY ON 15 DAYS WRITTEN NOTICE TO ABA FROM AN AUTHORIZED REPRESENTA- TIVE OF MEMBER AND WILL REMAIN IN FULL FORCE AND EFFECT UNTIL ANY SUCH REVOCATION.