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The form includes a financial institution completion section requiring routing transit number, account type, account number, and verification that the institution is ACH capable. 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The agreement remains effective until canceled, with timing rules for when changes and cancellations take effect.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What identification information is required from the business or individual?",{"text":114,"@type":110},"Provide the business/individual legal name, SSN or FEIN, and mailing address details including city, state, and ZIP in SECTION 2.",{"name":116,"@type":107,"acceptedAnswer":117},"What must the financial institution complete or verify?",{"text":118,"@type":110},"SECTION 3 requires the financial institution’s name and address, name on account, routing transit number, account type, and customer account number, along with verification that the institution is ACH capable and will comply with NACHA rules.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},306987,1790212474,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":4},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Direct Deposit Authorization Form  \nSECTION 1 – TRANSACTION TYPE  \n\n| ARE YOU ADDING, CHANGING OR CANCELING THIS AGREEMENT? |  | ADD |  | CHANGE |  | CANCEL |\n| --- | --- | --- | --- | --- | --- | --- |\n| The agreement represented by this authorization remains in effect until canceled by the payee and until such time, payments made by the State of Iowa to you will be deposited into the account at the financial institution designated below. You will be required to submit a new form for any change in banking designation or to cancel this authorization and revert to a state warrant. It is your responsibility to notify the State of Iowa any time an account is closed.\u003Cbr>An add or change in EFT status will be effective ten business days after entry into the State's accounting system. A cancelation will become effective immediately after entry into the State's accounting system. |  |  |  |  |  |  |\n\nSECTION 2 – BUSINESS/INDIVIDUAL IDENTIFICATION INFORMATION  \n\n| BUSINESS/INDIVIDUAL LEGAL NAME:  \u003Cbr>(NAME TAX ID IS ASSIGNED TO AND USED FOR TAX REPORTING)\u003Cbr>BUSINESS NAME:  (DBA – DOING BUSINESS AS NAME) IF DIFFERENT FROM LEGAL NAME |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n| SSN | | - | | - | | or FEIN (Fed. Employee ID Number)  - | |\n| MAILING ADDRESS:  \u003Cbr>(ADDRESS TO BE USED IN CASE OF DEFAULT TO CHECK)\u003Cbr>CITY:   STATE:   ZIP:   |  |  |  |  |  |  |  |\n\nSECTION 3 – FINANCIAL INSTITUTION – TO BE COMPLETED BY FINANCIAL INSTITUTION  \n\n| FINANCIAL INSTITUTION NAME:   FINANCIAL INSTITUTION ADDRESS:   CITY:   STATE:   ZIP:  \u003Cbr>NAME ON ACCOUNT:  \u003Cbr>ROUTING TRANSIT NUMBER: ACCOUNT TYPE: SAVINGS\u003Cbr>CUSTOMER ACCOUNT NUMBER: CHECKING\u003Cbr>\u003Cbr>\u003Cbr>|\n| --- |\n| I have verified the signature(s) and account numbers above. The Financial Institution is ACH capable and will comply with NACHA rules.\u003Cbr>REPRESENTATIVE NAME:   REPRESENTATIVE TITLE:  \u003Cbr>SIGNATURE:   DATE: \u003Cbr>TELEPHONE NUMBER:  |\n\n(NOT REQUIRED IF FOR CHECKING ACCOUNT ONLY AND A COPY OF VOIDED CHECK IS ATTACHED – DO NOT ATTACH DEPOSIT SLIP)  \nSECTION 4 – VENDOR AUTHORIZATION FOR ADD, CHANGE OR CANCELLATION  \n\n| I hereby authorize the Department of Administrative Services to deposit payments from the State of Iowa to the account designated on this form and to initiate any adjustments or debit entries to this account for any erroneous deposits in the amount of the error only. I also understand that the State of Iowa can only deposit funds into one\u003Cbr>financial institution and account. I certify that I am authorized to enter into this agreement as the account holder or on behalf of the account holder. |\n| --- |\n| AUTHORIZED NAME:   TITLE:   DATE:   AUTHORIZED SIGNATURE:   TELEPHONE NUMBER:   |\n\nMail or Fax Completed Form to: Fax Number: Telephone Number:  \nDept. of Administrative Services – State Accounting Enterprise (515) 281-5255 (515) 281-0246  \nATTN: EFT Coordinator  \nHoover State Office Building, 3rd FL  \nDes Moines, Iowa 50319 06/2012","cbCaineKcf6rAugK","https://ap.wps.com/l/cbCaineKcf6rAugK","pdf",87072,"English","# SECTION 1 – TRANSACTION TYPE\n# SECTION 2 – BUSINESS/INDIVIDUAL IDENTIFICATION INFORMATION\n# SECTION 3 – FINANCIAL INSTITUTION – TO BE COMPLETED BY FINANCIAL INSTITUTION\n# SECTION 4 – VENDOR AUTHORIZATION FOR ADD, CHANGE OR CANCELLATION","[{\"question\":\"How do I indicate whether I am adding, changing, or canceling the authorization?\",\"answer\":\"Select the appropriate option in SECTION 1 for Add, Change, or Cancel. The agreement remains effective until canceled, with timing rules for when changes and cancellations take effect.\"},{\"question\":\"What identification information is required from the business or individual?\",\"answer\":\"Provide the business/individual legal name, SSN or FEIN, and mailing address details including city, state, and ZIP in SECTION 2.\"},{\"question\":\"What must the financial institution complete or verify?\",\"answer\":\"SECTION 3 requires the financial institution’s name and address, name on account, routing transit number, account type, and customer account number, along with verification that the institution is ACH capable and will comply with NACHA rules.\"}]","Direct Deposit Authorization Form - Section 1-4 | PDF",1789842905]