Common Contracts
1 similar Authorization Agreement for Electronic Funds Transfer (Eft) contracts
Authorization Agreement for Electronic Funds Transfer (EFT)Authorization Agreement for Electronic Funds Transfer (Eft) • June 2nd, 2021
This form must be submitted through the ProviderOne Portal. Only social services and medical providers need to submit changes through ProviderOne. Please read completely before filling out your EFT authorization form. Failure to fill out your Authorization Agreement for EFT entirely with accurate information could result in update delays.
