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Automatic Clearing House (ACH) Request

  1. Vendor Information

  2. Signature*

    By selecting "I Agree" you are authorizing the City of North Richland Hills to make ACH payments using the information provided. You are also confirming that you are a representative authorized to submit this information and make these decisions on behalf of said company.

  3. Leave This Blank:

  4. This field is not part of the form submission.