ESBD_389137_1736284832969_SOL_EXH_F.4_DDFORM.pdf

This is a State of Texas Direct Deposit Authorization form (Form 74-176) used by vendors, individual recipients, or state employees to receive payments from the state of Texas by direct deposit or to change/cancel existing direct deposit information. The form contains several sections including transaction types, payee identification, new account information, existing account information, international payments verification, and authorization requirements.

The form requires detailed banking information including routing numbers, account numbers, and account types (checking or savings). It includes verification of whether payments will be forwarded to financial institutions outside the United States, requiring additional documentation (Form 74-227) if international transfers are involved. The form must be signed by both the payee and state agency representatives, with specific sections designated for state agency use only, including cancellation reasons and agency contact information. Contact information is provided for questions, directing state employees to their HR department, vendors/recipients to accounts payable staff, and state agencies to Fiscal Management Payment Services at 512-936-8138.