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Electronic Funds Transfer Authorization Form

Monday, February 11, 2013

This form authorizes DCRB to send payments ("direct deposits") to the designated bank account. This document remains in effect until cancelled in writing prior to the distribution being processed. Please allow thirty (30) to sixty (60) days after this authorization is received by DCRB for payments to be deposited. If you have any questions, please contact the DCRB Member Services Center by telephone at (202) 343-3272 or toll free at (866) 456-3272.