Below is a copy of the " (Electronic Funds Transfer/Direct Deposit) form and instructions" made available by the Pennsylvania Support Collection and Disbursement Unit (SCDU):
PA SCDU Direct Deposit Enrollment Form
The payee must fill in all the requested information in Section 1. The bank/financial institution must complete Section 2. Mail the completed form to: PA SCDU, PO Box 60948, Harrisburg, PA 17106-0948.
· The Payee must advise PA SCDU in writing of any account or address changes in order to remain enrolled in Direct Deposit.
· The account where the money is to be deposited must belong to the payee of the child support.
· The last name on the account must match the name of the payee on file in the Pennsylvania Child Support System, PACSES.
New Enrollment Account Change Cancel Direct Deposit
Section 1 (to be completed by payee)
Please Print
Name of Payee
Type of Depositor Account
Checking Savings
Address
Depositor checking/savings account number
City State Zip Code
PACSES Member ID
Area Code andTelephone Number
Name of Person Entitled To The Payment
Social Security Number
Signature Date:
Section 2 (to be completed by Bank/Financial Institution)
Name of Bank/Financial Institution
Routing number Check Digit
-
Account Number
Name of Bank Representative
Signature of Bank Representative
Telephone number/ Date
Completed forms should be sent via US Mail to PA SCDU, PO Box 60948, Harrisburg, PA 17106-0948.
All incomplete or incorrect enrollment forms will be returned to the sender for correction or additions.
3
Re: Your Request for Direct Deposit Enrollment Form
Dear Support Payee:
Enclosed please find the Direct Deposit enrollment form you requested. Please complete Section 1 of the form and have your bank complete Section 2. Read all directions on the form carefully.
Before returning this form please check it to be sure that all requested information has been completed. When all information is complete return the form to PA SCDU, P.O. Box 60948 Harrisburg, PA 17106-0948. Please allow 30 days after submission of this form for the activation of your direct deposit.
If the information on this form is incomplete, the form will be returned to you along with a letter noting information is missing. Telephone calls or faxed information will not be accepted to complete this form.
Thank you for your interest in Direct Deposit. If you have any questions concerning this letter or the Direct Deposit Enrollment Form, please contact PA SCDU Customer Service at #877-727-7238.
