010109 010108 JP
2160 41
st
Avenue, Capitola CA 95010-2040
PH: (831) 454-9455, FAX: (831) 469-3712
Housing Choice Voucher Program (Section 8)
LANDLORD DIRECT DEPOSIT CHANGE
DIRECT DEPOSIT IS NOW REQUIRED FOR ALL LANDLORDS PARTICIPATING
IN THE SECTION 8 HOUSING VOUCHER PROGRAM
I am hereby requesting that the Direct Deposit payments for the above be CHANGED to the following:
Account type: * Checking ** Savings
Name(s) on Account: ____________________________________________________________
Bank Routing number: ___________________ Account number: ___________________
Please attach a *voided check or ** savings deposit slip for the new account. This change will not be valid
unless accompanied by a voided check or deposit slip. Mail or fax to the Housing Authority, attention
Finance Department.
Landlord name: _____________________________________________________
Landlord Address: _____________________________________________________
_____________________________________________________
Phone Number: _____________________________________________________
E-mail address (to confirm cancelation/change): _________________________________
I understand that this cancelation and/or change may take up to 30 days to take effect.
I hereby authorize the Housing Authority of the County of Santa Cruz to cancel and/or change the direct deposit
of Housing Assistance Payments to the above account.
Signature: _______________________________ Date: __________________
Print name: ______________________________
