Fillable Va Form 24-0296e - Eft Enrollment - United Kingdom (Page 2 of 2) in pdf

IMPORTANT INFORMATION - PLEASE READ CAREFULLY

The Debt Collection Improvement Act of 1996, which was signed into law on April 26, 1996, required all

Federal payments to be made by electronic fund transfer (EFT) beginning on January 1, 1999. The EFT

requirement can be waived in situations where converting to EFT will impose an undue hardship. For more

information about waivers, please contact the VA Regional Office shown below.

TO ENROLL IN A EFT PROGRAM OR CHANGE EXISTING EFT ACCOUNT

Complete Sections 1, 2, and 3 on the front of this form.

Sign your name in the Signature box under Payee Certification in Section 4.

If you have a joint account, the co-account owner should sign the Joint Account Holder's Certification, Section 5.

Mail the completed form to the address shown on the front of the form.

CHANGING ACCOUNTS OR CANCELLING EFT

Notify the American Embassy Federal Benefits Unit immediately if you decide to change or cancel your EFT

account. DO NOT close your old account until your benefits start coming to your new account or home

address. See CONTACT information below.

NOTICE TO JOINT ACCOUNT HOLDERS

If you have a joint account and should die, the co-owner of the account should:

1. Notify the American Embassy Federal Benefits Unit or the Department of Veterans Affairs

of your death as soon as possible; and,

2. Have the financial institution return all Department of Veterans Affairs benefit payments deposited into

the account on your behalf after the date of your death.

The co-owner of the account should acknowledge that he/she is aware of these requirements by signing the Joint

Account Certification in Section 5 on the front of this form.

CONTACT THE OFFICE(S) BELOW FOR ASSISTANCE OR ADDITIONAL INFORMATION

American Embassy

DEPARTMENT OF VETERANS AFFAIRS

Federal Benefits Unit

1000 Liberty Avenue

24 Grosvenor Square

Pittsburgh, PA 15222-4004

London, W1A2LQ, England

Telephone - 00 1 (412) 395-6272

Telephone: (020) 7499 9000 (8:30 a.m. - 1:00 p.m.)

E-mail - https://iris.va.gov

VA will not disclose information collected on this form to any source other than what has been authorized

PRIVACY ACT NOTICE:

under the Privacy Act of 1974 or Title 38, Code of Federal Regulations Section 1.576 for routine uses as identified in the VA

system of records 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records -

VA, published in the Federal Register. An example of a routine use is that the information will be used to process the payment data

from VA to the beneficiary's designated financial institution. Your obligation to respond is voluntary.

: We need this information in order to process payment data from VA to your account at the designated

RESPONDENT BURDEN

financial institution. Title 31 Code of Federal Regulations, Section 210.4, allows us to ask for this information. We estimate that

you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct

or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a

collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page

at If desired, you can call 00 1 (412) 395-6272 or E-mail -

https://iris.va.gov to get information on where to send comments or suggestions about this form.

VA FORM 24-0296e, JUL 2009

Va Form 24-0296e - Eft Enrollment - United Kingdom Page 2

Related Articles

Related forms

Related Categories