ࡱ> %'$q`  bjbjqPqP .::4z z z z  N P P P P P P $ ht  t  " " " .  N " N " " " "Ovz " N 0 " w "w" w" , " t t  dz z   ACH Collection Authorization Form I __________________, from the business known as ____________________________, authorize the employees of Greater Northwoods MLS, Inc. to automatically withdraw our membership dues, on a monthly basis, from the account listed below. I acknowledge that by signing below, I am indicating that I have the authority to grant such transfers from our deposit account listed below. By signing below, I also acknowledge that to modify or rescind this agreement, I must do so in a matter that is acceptable to the Greater Northwoods MLS, Inc. Please return a voided check with this completed document, for verification purposes. 1. Name of organization from which funds will be transferred: ___________________________________________. 2. Name of financial institution which deposit account is located: ___________________________________________. 3. ABA Routing Number of the above financial institution: ___________________________________________. 4. Deposit account number: _________________________. 5. Amount of funds to transfer per month. __________________. SIGNATURE OF AUTHORIZED DEPOSIT ACCOUNT SIGNER _______________________________________ %&A  h j h~`X5\h~`X5CJ(\h~`X$%&   J K x y   F G [ \ ]  ] ,1h/ =!"#$% @@@ NormalCJ_HaJmH sH tH DAD Default Paragraph FontViV  Table Normal :V 44 la (k(No List  z$%&JKxyFG[\]!!!t!t!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!$%&JKxyFG[\]00000000000000000000000000000000000 ]   }]]}~`X j=/^@hg( `@UnknownGz Times New Roman5Symbol3& z Arial"0h3f3fۦF!43HP?=2!ACH Collection Authorization FormM&I Dawn KennedyOh+'0  $0 P \ h t$ACH Collection Authorization FormM&INormalDawn Kennedy2Microsoft Office Word@@&@Ͳv@Ͳv՜.+,0 hp|  M&I "ACH Collection Authorization Form Title  !"#&Root Entry FNVv(1Table WordDocument.SummaryInformation(DocumentSummaryInformation8CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q