Electronic Deposit Authorization
If you would like to receive your Optuma payments via electronic deposit, please read, complete and sign this authorization form. Note that in some jurisdictions this is now the only method by which you can be paid by Optuma.
By signing this form, I authorize Optuma Pty Ltd to deposit funds directly into the account indicated below. I warrant that the details are correct, and I am responsible for any loss of funds associated with errors on this form.
July 17, 2019
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Document Name: Electronic Deposit Authorization
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