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DSHS Form 18-484 Automatic Payment Authorization and Electronic Funds Transfer Information - Washington (English / Arabic)

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  6. DSHS Form 18-484 Automatic Payment Authorization and Electronic Funds Transfer Information - Washington (English/Arabic)

DSHS Form 18-484 Automatic Payment Authorization and Electronic Funds Transfer Information - Washington (English / Arabic)

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Bank Authorization Form Payment Authorization Form Electronic Payment Direct Deposit Form Washington State Department of Social and Health Services Washington Legal Forms Legal United States Legal Forms
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