Electronic Deposit Application

ELECTRONIC DEPOSIT APPLICATION. This form is used by custodial parents to select how they would like to receive their child support payments. This form allows recipients to choose between two payment methods: direct deposit into a personal checking or savings account or receiving payments via the U.S. Bank ReliaCard, a prepaid debit card. To enroll in direct deposit, the applicant must provide personal information, including their Social Security Number, date of birth, mailing address, and case number(s), and attach a voided check or a bank statement to verify their account details. By signing the form, the applicant authorizes the OCSE to deposit payments directly into the specified account until written notice of termination is provided. If the recipient fails to update their banking information when an account is changed or closed, payments will automatically be issued via the ReliaCard. If the ReliaCard option is selected, any existing direct deposit arrangement is canceled, and payments for all cases associated with the applicant will be loaded onto the card. The form also includes information on potential fees associated with using the ReliaCard, such as out-of-network ATM withdrawals and expedited card replacement. www.FormsWorkflow.com