ESBD_387541_1734731765248_SOL_EXH_F.4_25R0007108_956-85_DDA.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 of Texas or to 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. The form contains multiple sections for payee identification, new account information, existing account information, international payments verification, and authorization requirements.

The form requires detailed banking information including routing numbers and account numbers, with sections to be completed by both the payee and financial institution representatives (recommended). It includes verification for international payments and requires authorization signatures from both the payee and state agency representatives. The form contains specific instructions for completion on page 2, with contact information provided for state employees, vendors/recipients, and state agencies who may have questions. For state employees, they should contact their HR department; vendors/recipients should contact the paying agency's accounts payable staff; and state agencies should contact Fiscal Management, Payment Services at 512-936-8138.