EFT Electronic Fund Transfer Authorization | Pdf Fpdf Docx | California

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EFT Electronic Fund Transfer Authorization | Pdf Fpdf Docx | California

Last updated: 12/27/2021

EFT Electronic Fund Transfer Authorization

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Description

EFT Electronic Fund Transfer Authorization, This authorization remains in full force and effect until the California Medicaid Program/Title XIX receives written notification from the provider of its termination, or until the California Medicaid Program/Title XIX or appointing authority deems it necessary to terminate the agreement. www.FormsWorkflow.com

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