ESBD_404240_1742834320365_SOL_EXH_F.4_DIRECTDEPOSIT.pdf

PDF 742 KB Posted

Attached to
Childress WS Lawn Service
Solicitation number
405-25R0011718
Issued by
Cameron County, Texas

About this file

This document is a Direct Deposit Authorization form from the State of Texas, designed for vendors, individual recipients, or state employees to establish or modify direct deposit payment information. The form allows users to set up new direct deposit accounts, change financial institutions, modify account numbers, or cancel existing direct deposit arrangements. It requires comprehensive details such as payee identification, banking information, routing numbers, account types, and authorization signatures across multiple sections.

The form includes provisions for both domestic and international payment verification, with a specific checkbox to indicate whether payments will be forwarded to a financial institution outside the United States. Key sections require detailed information including financial institution name, routing number, customer account number, account type (checking or savings), and mandatory authorization signatures. The document provides comprehensive instructions for completion, specifies contact information for state employees and vendors (including state agencies' human resources departments and payroll staff), and includes a Federal Privacy Act Statement explaining the purpose of collecting personal identification information.

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