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Evised 4/5/17 CEPS Sacramento ATTN: Direct Deposit PO Box 417010, Sacramento, CA 95841 916-348-1894 5825 Auburn Blvd Sacramento, CA 95841 www.CEPSonline.org Client Paycard UCI: Office: DT MOD SAC Client Acct Landlord/Vendor Acct Multiple CEPS locations Direct Deposit Authorization Agreement I, , hereby authorize CEPS to initiate automatic deposits to my account or to my BLAZEPAYS paycard at the financial institution named below.

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