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Division of Community Nutrition AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT (ACH CREDITS) (Please check only one) New Form Correction/Change WIC STAMP NUMBER STORE NAME: ADDRESS: CITY, STATE ZIP CODE:

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What is additional retailer specific information?

Additional retailer specific information refers to any additional details that a retailer may need to provide beyond the standard information required.

Who is required to file additional retailer specific information?

Retailers who have specific requirements or agreements with suppliers, manufacturers, or distributors may be required to file additional retailer specific information.

How to fill out additional retailer specific information?

Retailers can fill out additional retailer specific information by providing the requested details in the specified format or template provided by the relevant entity.

What is the purpose of additional retailer specific information?

The purpose of additional retailer specific information is to ensure that all necessary details are provided to meet the requirements of the supplier, manufacturer, or distributor.

What information must be reported on additional retailer specific information?

The information requested on additional retailer specific information may vary depending on the specific requirements or agreements with the supplier, manufacturer, or distributor.

How can I send additional retailer specific information for eSignature?

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