ESBD_447776_1755720341441_F.5 Direct Deposit Authorization Form (74-176).pdf

This document is a Direct Deposit Authorization form from the State of Texas. The form is designed for vendors, individual recipients, or state employees to set up, change, or cancel direct deposit information for receiving payments from the Texas Comptroller of Public Accounts. The form contains multiple sections for completing transaction types, payee identification, new account information, existing account details, international payment verification, and authorization for setup or changes.

The form requires detailed information including financial institution details, routing numbers, account types (checking or savings), and authorization signatures. It provides instructions for completing each section and includes contact information for state employees, vendors/recipients, and state agencies who may need assistance. The document emphasizes compliance with the National Automated Clearing House Association's rules and allows for electronic deposit of payments, with provisions for correcting erroneously deposited funds.