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 for vendors, individual recipients, or state employees to receive payments or modify existing direct deposit information. The form consists of eight sections covering transaction types, payee identification, new account information, existing account information, international payments verification, authorization for setup/changes/cancellation, cancellation by agency, and state agency contact details. The form requires specific identification information including either a Social Security Number, Texas Identification Number (TIN), or Employer Identification Number (EIN).

The form includes fields for financial institution details such as routing numbers, account numbers, and account types (checking or savings), with optional fields for financial representative information. It requires verification regarding international payments, with additional documentation (Form 74-227) needed if payments will be forwarded to institutions outside the United States. The form emphasizes completion by financial institutions for new account setups and changes, and includes sections for agency use with specific requirements for authorized signatures, dates, and contact information. All submissions must be returned to the paying agency at an address specified on the form.