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Authorization for Direct Debit

  1. I hereby authorize Uwchlan Township to debit funds from the account at the Financial Institution designated below. This authorization will remain in effect until I initiate the required stop action in such time and in such manner as to allow Uwchlan Township a reasonable opportunity to act upon it. I agree to notify Uwchlan Township if I wish to change the designated Financial Institution or account from which the funds are to be debited from 30 days prior to the effective date of such change. I understand that failure to do so may delay Uwchlan Township’s receipt of funds.
  2. Any questions regarding direct debit may be referred to 610-363-9450.
  3. Account*
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