ESBD_383151_1732055323419_SOL_EXH_F.5_405-24R0010854_Direct Deposit Authorization Form.pdf

This is a Direct Deposit Authorization Form (Form 74-176) from the State of Texas Comptroller's office, used by vendors, individual recipients, or state employees to receive payments or modify existing direct deposit information. The form contains multiple sections for transaction types including new setups, changes to financial institutions, account numbers, account types, and cancellations. It requires detailed payee identification information and banking details for both new and existing accounts.

The form includes verification requirements for international payments and requires authorization signatures from both the payee and state agency representatives. It contains specific instructions for completion by financial institutions and state agencies, with separate sections for agency use including cancellation reasons and contact information. The form must be returned to the paying agency at a specified address, and questions can be directed to specific departments: Human Resources for state employees, accounts payable staff for vendors/recipients, or Fiscal Management Payment Services at 512-936-8138 for state agencies.