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Dpss direct deposit form

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The document is a Direct Deposit Authorization Sign-Up Form for participants of the Department of Public Social Services. It outlines the process for individuals to enroll in direct deposit for their cash benefits, requiring them to provide personal and banking information. The form includes sections for the payee's details and certification, as well as a section for the depository institution to complete. It emphasizes the importance of accurate information and provides instructions for cancellation or changes to direct deposit arrangements.

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Click ‘Get Form’ to open the document in the editor.
Begin with Section 1, where you will enter your Payee Name, Case Number, and Case Name if applicable. Ensure that all information matches your official documents.
Select the type of account (Checking or Savings) and fill in your address, Social Security Number/Taxpayer ID, and telephone number accurately.
In the Payee Certification section, review the authorization statement carefully before signing and dating it to confirm your understanding of the direct deposit process.
Proceed to Section 2 for your Depository Institution details. Fill in the institution's name, account holder names, address, account number, and routing number as required.
Ensure that a representative from your depository institution completes their certification by signing and dating this section.
Finally, review all entries for accuracy before saving or exporting your completed form for submission.

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What does DPSS stand for in Los Angeles County?

Department of Public Social Services.

How do I apply for DPSS benefits?

You can apply online at , over the phone at (866) 613-3777, or in person at your local DPSS District Office.

How do I apply for employee assistance program?

Employees can call 1-800-222-0364 to receive counseling services 24 hours a day, 7 days a week. In person counseling may be arranged on a case by case basis. The EAP services are offered through Federal Occupational Health (FOH).