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By submitting this form, account holders authorize the service provider to initiate credit entries directly into their designated personal financial accounts. The document requires essential account holder information, detailed banking institution data, and specific routing and account number verification. To ensure accuracy and security, a voided check must accompany the completed and signed form, facilitating the swift processing of reimbursement funds within two business days. The authorization remains in effect until formal written notice of termination is received, providing a secure and reliable framework for managing health benefit disbursements.",{"@graph":63,"@context":123},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/direct-deposit-authorization-form-288549/288549/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/direct-deposit-authorization-form-288549/288549.png","ImageObject",442,249,{"name":88,"@type":89},"Aldword","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115,119],{"name":106,"@type":107,"acceptedAnswer":108},"What accounts can be authorized for direct deposit using this form?","Question",{"text":109,"@type":110},"This form is used to authorize direct deposits from Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA).","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How quickly will direct deposits post to the designated account?",{"text":114,"@type":110},"Direct deposits will post to the account within two business days of the plan’s payment processing.",{"name":116,"@type":107,"acceptedAnswer":117},"What documentation must be attached to this form?",{"text":118,"@type":110},"The form must be signed and include a copy of a voided check to be considered complete.",{"name":120,"@type":107,"acceptedAnswer":121},"How can the account holder terminate this authorization?",{"text":122,"@type":110},"The authorization remains in force until McGriff Flexible Benefit Services receives written notification from the account holder requesting its termination.","https://schema.org",{"og:url":78,"og:type":125,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":127,"canonical":78},"index,follow",{"doc_id":129,"site_id":56},288549,1789633621,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":88,"user_avatar":134,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":130,"read_time":4},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Direct Deposit Authorization Form  \nUse this form to authorize direct deposit from your flexible spending account (FSA) or health reimbursement account (HRA) . Direct deposits will post to the account you designate within two business days of your plan’s payment processing.  \nMail: McGriff Flexible Benefit Services  \nFlexible Reimbursement  \nPO Box 6400  \nGreenville, SC 29606-5035  \nFax: 1-252-293-9048 or 1-252-293-9049  \nEmail:  [flexclaims@mcgriffinsurance.com](flexclaims@mcgriffinsurance.com)  \nPlease print the following Account Holder Information  \nYour Employer’s Name   Account Holder Name  Social Security Number  Daytime Phone Number   Email Address    \nBank Account Information  \nBank Name  Bank Address City     \nState   \nZIP   \nRouting Number  Account Number    \nType of Account □ CHECKING or □ SAVINGS (Please check one)  \nAuthorization  \nI hereby authorize McGriff Flexible Benefit Services to initiate credit entries to the account indicated. I further authorize McGriff Flexible Benefit Services to initiate, if necessary, debit entries and adjustments to correct any credits entered in error. This authorization replaces any earlier or previous requestsand will remain in force until McGriff Flexible Benefit Services receives written notification from the account holder of its termination.  \nAccount Holder’s Signature  Date   \nThis form must be signed and include a copy of a voided check","cbCaifPMhFd8koX9","https://ap.wps.com/l/cbCaifPMhFd8koX9","pdf",248238,"English","# Direct Deposit Authorization Form\n## Account Holder Information\n## Bank Account Information\n## Authorization and Signature","[{\"question\":\"What accounts can be authorized for direct deposit using this form?\",\"answer\":\"This form is used to authorize direct deposits from Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA).\"},{\"question\":\"How quickly will direct deposits post to the designated account?\",\"answer\":\"Direct deposits will post to the account within two business days of the plan’s payment processing.\"},{\"question\":\"What documentation must be attached to this form?\",\"answer\":\"The form must be signed and include a copy of a voided check to be considered complete.\"},{\"question\":\"How can the account holder terminate this authorization?\",\"answer\":\"The authorization remains in force until McGriff Flexible Benefit Services receives written notification from the account holder requesting its termination.\"}]","Direct Deposit Authorization Form | PDF"]