ESBD_387119_1734712785779_SOL_EXH_F.4_405-25R0003361_910-65_Deposit.pdf

This is a Direct Deposit Authorization form from the State of Texas Comptroller of Public Accounts, used by vendors, individual recipients, or state employees to receive payments from the state or modify existing direct deposit information. The form allows for various transaction types including new setup, changes to financial institutions or account numbers, account type changes, and cancellations. It contains sections for payee identification, new account information, existing account information, international payments verification, and authorization requirements.

The form includes detailed instructions for completion and requires specific information such as routing numbers, account numbers, and authorized signatures. It must be returned to the paying agency at their designated address. For questions, state employees are directed to contact their HR department or payroll staff, vendors/recipients should contact the paying agency's accounts payable staff, and state agencies should contact Fiscal Management Payment Services at 512-936-8138. The form falls under Chapters 552 and 559 of the Government Code regarding rights to review and correct information.