ESBD_454859_1758142368966_SOL_EXH_F.4_Direct Deposit Authorization Form.pdf

This document is a Direct Deposit Authorization form issued by 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, change account numbers, or cancel existing direct deposit arrangements. It consists of multiple sections requiring detailed information such as payee identification, financial institution details, routing numbers, account types, and authorization signatures.

The form includes instructions for completing each section, with specific guidance for state employees, vendors, and state agencies. Key sections cover transaction types, payee identification, new account information, existing account changes, international payment verification, and authorization for setup or cancellation. The document provides contact information for state employees (agency Human Resources), vendors (paying agency's accounts payable staff), and state agencies (Fiscal Management Services) for questions or assistance. A Federal Privacy Act Statement on the second page indicates that providing a Social Security number is required for administrative and identification purposes.