Please complete this form and fax it to:
605-342-7195 or e-mail it to sales@expresscollections.com
Third Party Authorization Form
![signature pen laying on a piece of paper that says signature](https://paymyaccount.net/wp-content/uploads/2020/05/signature-e1589764621425.jpg)
* This agreement is not valid until signed by all parties. (Employee, Employer, and ECI Representative)
Please complete this form and fax it to:
605-342-7195 or e-mail it to sales@expresscollections.com
* This agreement is not valid until signed by all parties. (Employee, Employer, and ECI Representative)