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Payor Electronic Funds Transfer Change Form - Indiana

Payor Electronic Funds Transfer Change Form Form. This is a Indiana form and can be used in Child Support Circuit Court Marion Local County .
 Fillable pdf Last Modified 8/12/2010
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Marion County Clerk's Office Accounting Department 200 East Washington Street, W-123 Indianapolis, IN 46204 Fax (317) 327-4813 Phone (317) 327-8090 PAYOR ELECTRONIC FUNDS TRANSFER CHANGE FORM I would like to change/close my Electronic Funds Transfer account starting: CHECK THE APPROPRIATE OPTIONS: (1) (a) (b) (2) (3) (4) Change Electronic Funds Transfer Account to: Savings Checking Close my account. Change my amount from $ Other (explain) to $ Bank & Account # Bank & Account # (Print Name) (Signature) (Address) (Social Security #) (Date) (City, State, Zip ) (Day Time Phone #) (E-mail) Payor: This form must be presented to the Clerk's office 10 business days before the next scheduled transaction to be effective. Change of accounts will take 10 business days or more to be active. Any payments due on your account during that period must be paid at our Child Support payment windows. (initials) Please include a valid federal or state picture ID when returning this form. For Office Use only: Changes Rev 4-09 American LegalNet, Inc.
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