ESBD_452649_1757456139237_SOL_EXH_F.5_Direct Deposit Authorization Form (74-176).pdf

This document is a Direct Deposit Authorization form from the State of Texas for vendors, individual recipients, or state employees to set up or modify electronic payment information. The form allows users to establish new direct deposit accounts, change financial institutions, update account numbers, or cancel existing direct deposit arrangements. It requires detailed information including payee identification, financial institution details, routing numbers, account types (checking or savings), and authorization signatures.

The form includes multiple sections for transaction types, payee identification, new account setup, existing account changes, international payment verification, and agency-specific actions. Key requirements include providing identification numbers (such as Social Security number or Texas Identification Number), complete banking details, and authorization signatures. The form also includes optional fields for financial representative information and provides instructions for completion, with contact information for state employees, vendors, and state agencies to address questions or submit the form.