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CheckFreePay Corporation A Fiber Company 15 Sterling Drive P.O. Box 5044 Wallingford, CT 064927544 800.309.7668 www.checkfreepay.com IMPORTANT INFORMATION REGARDING REGULATORY REQUIREMENTS AND YOUR
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This form is a legal document by which a person gives consent for a specific action which cannot be revoked.
Any individual or entity involved in the specific action requiring consent.
The form must be completed with accurate information and signed by the consenting party.
The purpose is to legally document consent for a specific action that cannot be revoked.
The form must include details about the specific action, the consenting party, and any relevant dates.
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