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I authorize Kostic Healthcare to deposit my pay automatically to the account(s) indicated below and, if necessary, to adjust or reverse a deposit for any payroll entry made to my account in error. This authorization will remain in effect until I cancel it in writing and in such time as to afford Kostic Healthcare a reasonable opportunity to act on it.
*Note: Split payments are not available for contractors
Important: Please attach a voided check for each bank account to which funds should be deposited. You can upload your scanned voided check from the "Browse files" link .