"Direct Deposit Enrollment Authorization" - California

Direct Deposit Enrollment Authorization is a legal document that was released by the California Department of Child Support Services - a government authority operating within California.

Form Details:

  • The latest edition currently provided by the California Department of Child Support Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Child Support Services.

ADVERTISEMENT
ADVERTISEMENT

Download "Direct Deposit Enrollment Authorization" - California

Download PDF

Fill PDF online

Rate (4.4 / 5) 27 votes
Page background image
DIRECT DEPOSIT
C A L I F O R N I A
˜°˛˝˙ˆˇ˘ˆˇ˛˜ˇ
The State of California offers a Direct Deposit program as a faster, easier, and more secure option for receiving your child support payments.
To enroll, please complete and sign the application at the bottom or enroll by phone or online at
www.casdu.com
and select “Person Receiving Support”. For more enrollment information, please contact us at 1-866-901-3212.
Complete all the information below and mail to: California Department of Child Support Services, P.O. Box 989064, West Sacramento, CA 95798-9064.
FORM MUST BE SIGNED.
Child Support Participant Number
(if you do not have a
Name
(Last, First, and Middle Initial)
Participant Number, call 1-866-901-3212)
(Applications with no Participant Number WILL NOT BE PROCESSED)
Date of Birth
(Month / Day / Year)
BANK OR CREDIT UNION NAME
Social Security Number or *ITIN
* Individual Taxpayer Identification Number
Bank Phone Number
Address
(Please make sure this is your current address)
If this is an address change, please check box.
Address 1 — Street Address
Account Information
Checking
Savings
Address 2 — P.O. Box Number or Apartment Number
Account Number
City
Routing Transit Number
(the 9-digit number on the bottom of your check or your deposit slip)
State
Zip Code
Country
Home / Cell Number
(Please include Area Code)
* Attach a check or deposit slip pre-printed with name, account
number and routing number to this form before mailing.
Alternate Phone Number
(Please include Area Code)
Applications without a pre-printed check or deposit slip will not be
processed.
Email Address
Please sign and date the authorization section below to complete the application.
Direct Deposit Enrollment Authorization
By signing this form, I understand I am giving the California State Disbursement Unit (SDU) permission to deposit payments directly into the checking or savings account I
have listed above. I have verified that the bank routing number and my account number are accurate. I understand that if I have not provided accurate bank routing and
account numbers, the SDU and the California Department of Child Support Services are not liable for any mistake resulting from inaccurate account numbers. I assume
responsibility to verify deposits to my account on a timely basis and understand that the SDU is not responsible for any bank fees that my financial institution may charge.
This authorization is to remain in full force and effect until I cancel it by completing another Direct Deposit Authorization or I contact the California State Disbursement Unit at
1-866-901-3212. I understand that the SDU can cancel my participation in the direct deposit program, if necessary, without my written permission.
Signature
Date
DIRECT DEPOSIT
C A L I F O R N I A
˜°˛˝˙ˆˇ˘ˆˇ˛˜ˇ
The State of California offers a Direct Deposit program as a faster, easier, and more secure option for receiving your child support payments.
To enroll, please complete and sign the application at the bottom or enroll by phone or online at
www.casdu.com
and select “Person Receiving Support”. For more enrollment information, please contact us at 1-866-901-3212.
Complete all the information below and mail to: California Department of Child Support Services, P.O. Box 989064, West Sacramento, CA 95798-9064.
FORM MUST BE SIGNED.
Child Support Participant Number
(if you do not have a
Name
(Last, First, and Middle Initial)
Participant Number, call 1-866-901-3212)
(Applications with no Participant Number WILL NOT BE PROCESSED)
Date of Birth
(Month / Day / Year)
BANK OR CREDIT UNION NAME
Social Security Number or *ITIN
* Individual Taxpayer Identification Number
Bank Phone Number
Address
(Please make sure this is your current address)
If this is an address change, please check box.
Address 1 — Street Address
Account Information
Checking
Savings
Address 2 — P.O. Box Number or Apartment Number
Account Number
City
Routing Transit Number
(the 9-digit number on the bottom of your check or your deposit slip)
State
Zip Code
Country
Home / Cell Number
(Please include Area Code)
* Attach a check or deposit slip pre-printed with name, account
number and routing number to this form before mailing.
Alternate Phone Number
(Please include Area Code)
Applications without a pre-printed check or deposit slip will not be
processed.
Email Address
Please sign and date the authorization section below to complete the application.
Direct Deposit Enrollment Authorization
By signing this form, I understand I am giving the California State Disbursement Unit (SDU) permission to deposit payments directly into the checking or savings account I
have listed above. I have verified that the bank routing number and my account number are accurate. I understand that if I have not provided accurate bank routing and
account numbers, the SDU and the California Department of Child Support Services are not liable for any mistake resulting from inaccurate account numbers. I assume
responsibility to verify deposits to my account on a timely basis and understand that the SDU is not responsible for any bank fees that my financial institution may charge.
This authorization is to remain in full force and effect until I cancel it by completing another Direct Deposit Authorization or I contact the California State Disbursement Unit at
1-866-901-3212. I understand that the SDU can cancel my participation in the direct deposit program, if necessary, without my written permission.
Signature
Date