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Automatic Bank Draft Request

If you would like to enroll in our automatic bank draft, please fill out the form below, and a Nolin RECC representative will contact you regarding this request:

ex: xxx-xxx-xxxx
ex: xxx-xxx-xxxx
Your Nolin RECC account number you want to have drafted.
The name of your bank or credit union.
This is a unique number specific to your bank.
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
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