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EFTA01386965
FOR BANK USE ONLY CUSTOMER'S TRANSFER REQUEST: Complete appropriate boxes) FAX 0 IN PERSON PHONE O MAIL/MESSENGER I.O. USED Marta leave blank) O Telephone/Fax agreement on file CALLBACK IF OVER $ LIMIT: il One tine only transaction O Hold placed By O SOoke to I N lime TAKEN IN BY (Print Name) INIT
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