Please see the example below. You must fill out all the applicable sections:
Section 1: Type of Request
- Please select one of the following:
- New Request for direct deposit
- Change current direct deposit
Section 2: Customer/Vendor/Payee Information
- Full name of the owner
- Social Security or Tax I.D.
- Phone number
- Address
- Email address (if applicable)
Section 3: Direct deposit information
- Checking or savings
- Account holders name
- Bank name
- Routing number
- Account number
- Signature and date

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