ESBD_466896_1762279506766_SOL_EXH_F.4_Direct Deposit Authorization Form.pdf

This document is the State of Texas Direct Deposit Authorization Form 74-176, which enables vendors, individual recipients, and state employees to establish or modify direct deposit arrangements with the State of Texas Comptroller of Public Accounts. The form facilitates multiple transaction types including new account setup, changes to financial institutions, account number modifications, account type changes, and cancellation of direct deposit services. No specific products or services are requested, project timelines, quantities, meetings, or contract award dates are applicable to this form, as it serves as an administrative mechanism for payment processing rather than a procurement document for goods or services.

The form requires payees to provide identification information, specify financial institution details including routing and account numbers, and authorize the state agency to process electronic deposits. Payees must indicate whether payments will be forwarded to financial institutions outside the United States and, if so, complete the ACH Payment Destination Confirmation Form 74-227. The authorization requires original signatures from both the payee and authorized state agency representatives. The form accommodates state employees, vendors, and other recipients and can be used to cancel existing direct deposit arrangements at any time. Completion by the financial institution is recommended to ensure accuracy of banking information.