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We are required to have on file a signed authorization form due to a change in bank policies concerning ACH payments. Please print and fill out the ACH Authorization form and mail or fax it in to be able to submit online ACH payments. Your payment will not be processed if we do not have a signed form on file.
If you already have mailed or faxed a form please disregard this message. For more
information regarding this policy please contact our billing department at firstname.lastname@example.org.
Please print and fill out the ACH Authorization form and mail or fax it in to be able to submit online ACH payments.