EMPLOYER AUTHORIZATION AGREEMENT FOR ONE-TIME DEBIT (ACH)Employer Authorization Agreement • June 1st, 2017
Complete this Employer Authorization Agreement for One-Time Debit (ACH) for Pension Fund to debit the Employer's bank account for a one-time deposit to one or more member accounts at Pension Fund. This Agreement will apply to the employee(s) and/or program(s) identified below. If the Employer wishes to debit different bank accounts for deposits to different programs, the Employer must complete a separate Agreement for each program.
EMPLOYER AUTHORIZATION AGREEMENT FOR RECURRING DEBIT (ACH)Employer Authorization Agreement • June 1st, 2017
Complete this Employer Authorization Agreement for Recurring Debit (ACH) for Pension Fund to debit the Employer's bank account each month for deposit to one or more member accounts at Pension Fund. This Agreement will apply to the employee(s) and/or program(s) identified below. If the Employer wishes to debit different bank accounts for deposits to different programs, the Employer must complete a separate Agreement for each program.
EMPLOYER AUTHORIZATION AGREEMENT FOR ONE-TIME DEBIT (ACH)Employer Authorization Agreement • June 1st, 2017
Complete this Employer Authorization Agreement for One-Time Debit (ACH) for Pension Fund to debit the Employer's bank account for a one-time deposit to one or more member accounts at Pension Fund. This Agreement will apply to the employee(s) and/or program(s) identified below. If the Employer wishes to debit different bank accounts for deposits to different programs, the Employer must complete a separate Agreement for each program.
WV Personal Options Employer Transition Enrollment PacketEmployer Authorization Agreement • January 23rd, 2024
Thank you for choosing Palco to direct your care. This packet contains all the forms you need to enroll as an employer in self-direction and begin paying your worker. Please make sure to follow all directions in this packet.
