Address where deposit tickets should be sent:
Agency: __________________________________________________________________________________________
Address (No PO box; must be street address): ___________________________________________________________
_________________________________________________________________________________________________
Attention to: ______________________________________________________________________________________
City: _______________________ State: _______________________ Zip Code: _______________________
Endorsement Stamp:
New endorsement stamp needed? Yes ________ No ________
Endorsement stamps will be ordered as follows and shipped to the agency contact:
FOR DEPOSIT ONLY
STATE OF WEST VIRGINIA
_______________________________________________
“AGENCY NAME” (Can include deposit location number too)
_______________________________________________
“BANK ACCOUNT” (e.g. BB&T “acct. #”) *STO to complete
Agency Contact Information:
Agency Contact Name: ___________________________________________________________________________
Agency Contact Address: ___________________________________________________________________________
City: _______________________ State: _______________________ Zip Code: _______________________
Agency Contact Phone Number: ____________________________________________________________________
Agency Contact Email Address: ____________________________________________________________________
Signature: _______________________________________ Date: ________________________
*You may email ReconGroup@wvsto.com or call 304-558-3599 for questions regarding this form.
**Email completed form to ReconGroup@wvsto.com or fax to 304-340-1511.
***If your spending unit accepts credit cards, either via the WVSTO’s e-government platform or through
payment terminals, you must have policies and procedures in effect at your spending unit to insure proper
credit card handling and safeguarding of credit card information as it relates to e-government and point-of-
sale transactions. The Credit Card Handling Handbook is available on the STO’s website located here:
http://www.wvsto.com/Portals/wvtreasury/content/Banking/Accounting/Credit%20Card%20Handling%20H
andbook.pdf. It provides valuable information for your spending unit in credit card handling.
