ESBD_388291_1735845606448_SOL_EXH_F.4_405-25R0002669_726-84_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 setups, changes to financial institutions or account numbers, changes to account types, and cancellations. It contains 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 a preference for financial institution completion of certain sections. It includes verification of whether payments will be forwarded to financial institutions outside the United States, which requires additional documentation (Form 74-227) if applicable. The form must be signed by authorized representatives and includes provisions for state agency use, including cancellation procedures and agency contact information. For questions, state employees are directed to 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.