NORTH DAKOTA PUBLIC EMPLOYEES RETIREMENT SYSTEM …

AUTHORIZATION FOR AUTOMATIC PREMIUM DEDUCTION : 50134 . CONTINUATION OF COVERAGE IN MEDICAL SPENDING ACCOUNT (COBRA) 53512 . ... form to initiate electronic fund transfer (EFT) of my retirement funds into my account as indicated above. ... PART E AUTHORIZATION .

  Electronic, Automatic, Authorization, Fund, Transfer, Deduction, Electronic fund transfer