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Click ‘Get Form’ to open the Authorization for Direct Deposit form in the editor.
Begin by entering your Payee Name and Social Security Number in the designated fields. Ensure that all entries are typed or printed clearly.
Indicate your Gender and Date of Birth accurately to avoid any processing delays.
If applicable, provide your Former Last Name, especially if it was used in this system previously.
Select which monthly pension account(s) this authorization affects by checking all appropriate boxes: My retirement benefit, Survivor annuitant benefit, or Divorce Benefit.
In the Payee Agreement section, review the terms carefully before signing. This confirms your authorization for electronic deposit.
Fill in your Depositor Account Number, Area Code/Telephone Number, and details of your Financial Institution including its Name, Address, City, State, Routing Number, and Account Type (Checking or Savings).
Finally, sign and date the form to complete your submission. Make sure to save your changes before exporting or sharing the document.
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Current/Former Class of Service as a PSERS member: Certification: I DocHub that I have received information regarding the retirement plans available toRead more
These forms are also available by contacting PSERS. To avoid delays or errors, before you complete an application for retirement or disability retirementRead more
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