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OSUWMC Electronic Funds Transfer Set-Up Form
This form is used to collect the required information to set-up the Electronic Funds Transfer of Funds between The Ohio State. University Wexner Medical
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To request EFT of New York Medicaid funds, complete all sections of the form below. Questions about completing this form should be directed to eMedNY Call
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Nov 14, 2022 All EFT accounts are tied to an address in our system; a form is required for each address (if needed). The entity listed hereby
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