ESBD_392780_1737991294108_SOL_EXH_F.5_Direct 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 or modify existing direct deposit information. The form contains multiple sections for transaction types including new setup, changes to financial institutions or account numbers, account type changes, and cancellations. The form requires completion by both the payee and financial institution representatives, with various authorization signatures needed throughout the process.

The form captures detailed financial information including routing numbers, account numbers, and account types (checking or savings), along with verification for international payments. A key requirement is authorization from the payee acknowledging that the Texas Comptroller of Public Accounts will electronically deposit payments and that any erroneous deposits will be reversed. The form includes sections for state agency use, with specific fields for agency representatives to complete cancellations and provide contact information. Agencies must coordinate with their Human Resource departments or payroll staff for state employees, accounts payable staff for vendors/recipients, or contact Fiscal Management Payment Services at 512-936-8138 for assistance.