Direct Deposit Authorization Form
If you would prefer to have future payments deposited directly
into your bank account, please fill out and return via mail, fax or email..
ACH deposit advices are sent via USPS to the “Remit To Address” indicated below.
Vendor Information
Business Name
Tax ID Number
Remit to
Address
City
State
Zip
Contact Name
Phone
Email Address
Bank Information
Bank Name
Bank Routing (ABA)
Number (9 digit number)
Bank Account
Number
One of the following MUST be included for verification:
Voided Check
Specification form from Bank
* * Do not use a deposit slip * *
Authorization
I, _______________________, as an authorized signer for ____________________, do
hereby authorize the City of Garland to deposit payments by direct deposit (ACH) directly
into the above specified bank account.
___
Authorized Signature Title
Date
Mail to:
City of Garland Housing
210 Carver Suite 201B
Garland, TX 75040
Fax to:
972-205-3388
E-mail to:
kgorman@garlandtx.gov
click to sign
signature
click to edit
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