Department of Financial Services
Division of Accounting and Auditing – Bureau of Vendor Relations
Instructions for Direct Deposit Authorization
Please contact us at (850) 413-5517 or e-mail at DirectDeposit@MyFloridaCFO.com if you have any questions or need
assistance.
Section 1: Transaction Type: Select the appropriate transaction type(s):
• New request - If a payee is not currently on direct deposit with the state.
• Change –If payee has a current direct deposit with the state and is requesting a change to the record. (example:
change of payee name, financial institution, account number and etc)
Section 2: Authorization for Setup or Changes: Enter the information of the Payee.
Note: The social security number is required to be collected pursuant to 26 USC 6109, and will only be used for the purpose of
complying with filing requirements imposed by the Internal Revenue Code and to comply with Section 119.071(5)(a)7, F.S.
The name on the Direct Deposit Payment Authorization Form must match the Payee name on file with the State of Florida
Vendor payment system for payments to be sent electronically. If you are currently receiving payments via State warrant, you
should list the first line of Payee exactly as it appears on the State of Florida warrant.
Payees have the option to receive a paper copy of the direct deposit information by mail. Please note that the information is
available online at http://flair.dbf.state.fl.us/dispub2/cvnhphst.htm immediately after the payment is deposited into the
payees designated account.
Section 3: Financial Institution: Contact your financial institution to confirm your direct deposit account information. Have the
completed form signed by a Representative of the Financial Institution. The individual authorizing the form must be an
authorized signer on the bank account that the funds are being sent to. Verification will be conducted by the Department, via a
telephone call to the Authorized Signer, to confirm the business name, account and transit-routing information of the financial
institution.
Section 4: International ACH Transactions (IAT): Check this box if your funds are deposited in a U.S. financial institution and the
entire amount is subsequently forwarded to a financial institution in a foreign country. Banking industry rules require the
State, as originator of electronic payments, to identify payments where the entire payment amount is subsequently transferred
to a financial institution outside the United States. The rules are referred to as “International ACH Transaction (IAT) rules” and
are pursuant to requirements of the Office of Foreign Assets Control (OFAC), which is part of the United States Treasury. If an
electronic payment is identified as an IAT transaction, the electronic payment must be sent to your financial institution in a
special format. Contact your Financial Institution to see if IAT rules apply to you.
The State of Florida does not send payments electronically to financial institutions outside the United States.
Terms and Conditions
Processing time is approximately 4 to 6 weeks following receipt of the completed form. Please complete all information
requested on this form.
Providing account information does not authorize the State of Florida to access account activity on your account.
We will initiate a pre-notification to your financial institution prior to making payment based on this authorization. The pre-
notification is a zero dollar entry transmitted to your financial institution for the purpose of verifying the accuracy of the
account and transit-routing numbers provided and entered into our system.
An authorized representative of the payee must make any changes to the information provided on this form in writing. Changes
to account information will cause the original authorization to be immediately inactivated and the new account information will
be processed as described above. The authorization will remain in effect until terminated in writing with sufficient notice to the
State to allow adequate time to effect termination. The State will not be responsible for any loss that may arise solely by reason
of error, mistake or fraud regarding information provided on this Direct Deposit Payment Authorization Form.
The State cannot send payments to different accounts at this time. All payments from the State of Florida will be sent to the
single account you designate.
DFS-AI-26E rev 6/2014
