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Medical Supply Inc
Medical Supply Inc
Medical Supply Inc.
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Direct Deposit Form


Circle one:

I hereby authorize MSI to deposit my paycheck directly into the above mentioned account. This authority will remain in effect until I have given written notice that I am terminating this contract, or until MSI has notified me that this deposit service has been discontinued. I understand that I must give advance notice to allow reasonable time for my instruction to be executed. If an incorrect deposit should be made into my bank account, I authorize my bank and MSI to make the appropriate adjustment(s).

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