​Bank release Application

​​Complete the form below ​for Financial Authorization​ to ​release ​confidential ​information.

  • FIRM INFORMATION



  • BANK INFORMATION

  • My Bank details are as follows:

​Secure form ​to send us your Banking information

  • FIRM INFORMATION



  • BANK INFORMATION

  • My Bank details are as follows:

​Secure form ​to send us your Banking information.

Dialectic Distribution