DEBIT INFORMATION. Complete the following information for each employee and each program to which this Agreement applies. Member Ref. No. Member Name Program* Account Number Debit Amount $ $ $ $ $ $ TOTAL DEBIT: $ *A program may be the Pension Plan, Tax-Deferred Retirement Account (TDRA), Benefit Accumulation Account (BAA), ▇▇▇▇ ▇▇▇, and/or Traditional IRA. Special Instructions
Appears in 2 contracts
Sources: Employer Authorization Agreement for One Time Debit (Ach), Employer Authorization Agreement for One Time Debit (Ach)