Raley’s Family of Fine Stores

AUTHORIZATION & ACH PAYMENT SET-UP FORM. To be completed by the Trading Partner Page One. 1. Trading Partner Name: 2. Remit to Address (line 1): Remit to Address (line 2): City: State/Province: Zip / Postal Code: 3. Contact Name: Contact Phone #: 4. E-mail address for payment detail: 5. PAYMENT … ................
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