Cancel. I hereby authorize Meritain Health, ▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇, hereinafter called COMPANY, to initiate debit entries from my account indicated below and the depository name, hereinafter called DEPOSITORY, to debit the same account.
Appears in 3 contracts
Sources: Employer Application, Employer Application, Employer Application