Direct Deposit Request First Name * Last Name * You are allowed direct deposit to one account only. TO SET UP or CHANGE A DIRECT DEPOSIT please do the following: 1. Fill out the information below COMPLETELY 2. Attach a voided check or a comparable document given to you by your bank for setting up direct deposits. To CANCEL your direct deposit simply check the box and sign. Please Select One * Initial Enrollment Change of Account Cancellation Account Type * Checking Savings Bank Name * City and State Account # * Routing # * Nine digit number located in the lower left hand corner of your check. Attach Voided Check or Bank Letter Drop a file here or click to upload Choose File Maximum file size: 268.44MB Incomplete Forms Will Not Be Processed Additional Instructions Signature * Clear Date If you are human, leave this field blank. Submit