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Get and Sign Direction to Pay Form IAnet Ianetwork

Get and Sign Direction to Pay Form

Use a direction to pay form 0 template to make your document workflow more streamlined.

______________________________________________________ Insurance Company ___________________________________ Claim # _____________________________________________________ DIRECTION TO PAY I authorize _____________________________________________ Insurance Company to pay ____________________________________ directly on claim number ________________________________ in the amount of $___________________. In the event the insurance or adjustment company inadvertently mails the...
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