ESBD_434312_1752083557238_SOL_EXH_F.4_405-PILATUS-PC12_Direct Deposit Authorization.pdf

This document is a Direct Deposit Authorization form from the State of Texas, specifically issued by the Texas Department of Public Safety (Agency Number 405). The form is designed to allow state employees, vendors, or other recipients to set up, modify, or cancel direct deposit payment information. The form provides comprehensive sections for transaction types, payee identification, new account setup, existing account changes, international payment verification, and authorization for setup or cancellation.

The form requires detailed information including financial institution routing numbers, account types (checking or savings), and authorization signatures. It includes instructions for completing each section and provides contact information for various inquiries, with the return address specified as the Texas Department of Public Safety, Accounts Payable/Direct Deposit Program in Austin, TX. The document also includes a Federal Privacy Act Statement on the second page, indicating compliance with federal guidelines for handling personal and financial information.