Please note that you may fill out these forms online; however, you must print
out the completed form and mail it to your paying agency. Use the tab
key to move from field to field on the form. Please make sure that
you provide accurate banking information. If you are not sure what your
account and routing numbers are, please contact your financial institution
for these numbers.
If you are receiving Federal benefit payments, please follow these
directions:
Complete the Direct Deposit form online.
Print out the form.
Contact your financial institution and ask it if it will be able to transmit electronically your enrollment information to your agency through a process known as Automated Enrollment.
If your financial institution offers this service, please take a completed form to your financial institution and ask it to send the form to your paying agency by Automated Enrollment. Please also ask the financial institution to confirm your banking information before transmitting your enrollment.
If your financial institution does not offer this service, please confirm your banking information with your financial institution and mail the completed form to your agency.
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is free to download.