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Form # CMS 588
Form Title Electronic Funds Transfer (EFT) Authorization Agreement
Revision Date 08/31/2006
O.M.B. # 0938-0626
O.M.B. Expiration Date 08/31/2009
CMS Manual N/A
Special Instructions N/A

 


 
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CMS 588 (451KB)
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Last Modified Date : 10/20/2008
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