ESBD_430149_1750712547268_SOL_EXH_F.4_DIRECTDEPOSIT.pdf

PDF 742 KB Posted

Attached to
SRIS SYSTEM COMPONENTS REPAIR
Solicitation number
405-25R0022141
Issued by
Texas

About this file

This document is a Direct Deposit Authorization form from the State of Texas 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 provides comprehensive sections for payee identification, new account information, existing account details, international payment verification, and authorization for setup, changes, or cancellation.

The form requires detailed information including financial institution name, routing number, customer account number, account type (checking or savings), and mandates an authorized signature for validation. It includes specific instructions for completion, with recommended input from the financial institution. The document is designed to facilitate electronic payments from the Texas Comptroller of Public Accounts, ensuring accurate and secure financial transactions for state-related payments. Optional fields allow for additional contact information and representative details, while maintaining compliance with federal privacy regulations.

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