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This form authorizes TIAA-CREF's lead bank to transfer funds for premium remittances from your local bank account to a TIAA-CREF account. Complete and return this authorization with a voided check to TIAA-CREF.

TIAA-CREF is hereby authorized to instruct its lead bank to present Automated Clearing House (ACH) transactions or Depository Transfer Checks (DT) on my account indicated below at the depository institution named.

Institution Name  
Institution Address  
  Street Address 
  City
  State
  Zip Code 
 
Name/Title of Institution Contact  
 
Institution Phone Number  
 
Premium Payment Group Code  
 
Bank Name  
 
Bank Address  
  Street Address 
  City 
  State
  Zip Code 
 
Title of Account  
 
Account Number  
 
ABA Number
*(must be 9 digits)
 
   
 

These transactions will indicate "debit" and will be payable to TIAA-CREF's lead bank for the credit of TIAA-CREF only.

This authorization does not affect our primary obligation for payment. This authorization is to remain in effect until TIAA-CREF is notified in writing to the contrary.


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