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order to receive payment complete the attached EFT enrollment form. Do not proceed with compliance: Most will meal 550e without prior approval of Budget °Mkt I Fax any request to (305)530-7679 • 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor 12 Signature of Financial In

ORM 0110-211 APR. 84 EFTA01660251 • GENERAL This is a multi-purpose form designed to sane as an Authorization, Purchase Oder, Itemized Invoice, Receiving Report and Payment voucher in conjunction with 'requests for financial information, pursuant to the Right toFinancial Privacy Act of 1978, P.L. 95430, Tide