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HRA Recurring Claim Form
This should be filled out and sent to the Accounting Department at the Board Office.  This form is to be filled out if you want your monthly Dental Premium to come directly out of your HRA.  Please remember to date and sign the form.

ACH Form
This should be filled out and sent to the Accounting Department at the Board Office.  This form is to be filled out if you want your monthly Dental Premium to come directly out of your personal bank account.  Please remember to date and sign the form.