Direct Deposit Authorization Form Page 2
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1
2EFT IS MANDATORY
FOR VENDOR PAYMENTS AND EMPLOYEE TRAVEL PAYMENTS
)
(UNLESS A WAIVER IS GRANTED
Public Law (PL) 104-134, the Debt Collection Improvement Act of 1996, requires that all federal payments with few exceptions be
made via Electronic Funds Transfer (EFT).
Reference: Department of the Army, U.S. Army Corps of Engineers, CERM-F letter dated 8 Feb 1999,
Subject: Implementation for Electronic Funds Transfer (EFT) for Federal Payments
In order to comply with this requirement, complete the Direct Deposit Form on the back of this notice and return it. If you are unsure
of routing or account numbers consult with your financial institution to fill out the bottom portion of the form. Once EFT is
established, instead of receiving checks, you will have payments directly deposited into your checking or savings account.
(If you have already signed up, please disregard).
Utility and Phone Companies – In order to facilitate establishing acceptable invoice numbers please call point of contact.
POINTS OF CONTACT for questions are:
901-874-8543 (Commercial)
901-874-8478 (Commercial)
882-8543 (DSN)
882-8478 (DSN)
CEFC-FC-EFT@usace.army.mil
INSTRUCTIONS FOR COMPLETING FORM UFC-DISB-4
(1)
Vendors and/or travelers should indicate if this transaction is an “add” as a new Direct Deposit to be set up or a change to
the already existing information. USACE employees already on payroll Direct Deposit that have not completed a form for
travel reimbursements should mark Add.
(2)
Include the Corps of Engineers District name (example Mobile) or
EROC (example: K5) that wrote the contract authorizing payment. If
LOOK AT YOUR TREASURY CHECK
more than one District issued contracts, prepare a separate form for
.
Check #
each District.
CONTRACT NUMBER
COMPANY NAME & ADDRESS
(3)
Include the Name Or Company as it appears on the invoice. If the
EROC
contract was written to Bill and Betty Smith, the bill and Direct Deposit
form should include both names, not just Bill. If you are a Corps
Employee, this will be your name.
(4)
This address is the physical address of the business. If you are a
Corps employee, this is your home address.
(5)
The city, state, and zip that match the physical address.
(6)
The mailing address will include any and all remit to/payment addresses that are different from the physical address. If
more space is needed, include as attachment page with all addresses listed. This is VERY IMPORTANT the routing and
bank account number is loaded on specific payment addresses.
(7)
Include Daytime phone number in case there are questions concerning the completed form.
(8)
Check if the bank account number furnished is a checking account.
(9)
Check if the bank account number furnished is a saving account.
(10)
Include bank account number, one number in each slot. This number for checking account is located on the bottom
portion of your checks, usually after a nine digit number. Do not include the check number which sometimes appears in
front or behind the actual account number.
(11)
The full name of your bank.
(12)
The actual street address or PO BOX of your bank/financial institution.
.
(13)
The City, State, and Zip Code of your bank/financial institution
(14)
The Bank’s routing number. This is your bank’s identification number in the Federal Reserve System. Every bank’s
routing number consists of exactly nine numeric numbers. To locate your bank’s routing number look at the bottom of your
check at those series of numbers. You should find a
John Citizen
Check ###
series of nine numbers either “off to themselves” or
Your Address
Your Bank
between colons. This is your bank’s routing number.
(15)
Depositor Account Title (Name on bank account)
Pay to the Order of _____________________________________ $__________
(16)
“For Corporations and Businesses, use the companies
_______________________________________________________Dollars
IRS Tax ID number. For Sole Proprietorships and
Bank Name
Individuals, write your social security number.
Bank Address
(17)
Forms for businesses should be signed by a company
Bank City/State/Zip
officer. Forms for Employees/individuals should be
*: 123456789*:
Check ### Your Account Number
signed by the specific person.
(18)
Date of Authorization (i.e. Date Signed)
COMPLETED FORMS MAY BE EMAILED TO THE POINTS OF CONTACT OR FAXED TO THE
DISBURSING OFFICE AT 901-874-8572 or 901-874-8574
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