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Antigua & Barbuda Social Security Board
ELECTRONIC FUNDS TRANSFER (EFT)
AUTHORIZATION FORM
Please complete and email this form to: remittance@socialsecurity.gov.ag after your EFT
transaction.
EFT transaction information
Company Name:
Antigua Barbuda Social Security Board
BANKING DETAILS
Payee Name on Acc... | : __________________________________
(six (6) digit only)
Remittance Month: ________________________________
(mm/yyyy)
EFT Transaction/Receipt No: ________________________
EFT Transaction Amount: __________________________
Remember to sign and date all R5As then email to remittance@socialsecu... |
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