Direct Deposit Authorization Agreement

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I hereby authorize Greater Home Health Services to initiate credit or debit entries to my account with the Financial Institution indicated below. This authority is to remain in full force and effect until Greater Home Health Services has received written notification from me of its termination in such time and in such manner as to afford Greater Home Health Services and the Financial Institution a reasonable opportunity to act on it. I understand this authorization is for reimbursements from my employer-sponsored reimbursement account plan.

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