Eft online application: Fill out & sign online

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How to use or fill out (EFT) Direct Deposit Form with our platform

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Click ‘Get Form’ to open the EFT Direct Deposit Form in the editor.
Begin by filling out the Provider Information section. Enter your *Provider Name*, *Street Address*, *City*, *State/Province*, and *Zip Code/Postal Code*. Ensure all fields marked with an asterisk (*) are completed.
In the Provider Identifiers Information section, provide your *Federal Tax Identification Number (TIN)*, *National Provider Identifier (NPI)*, and any other identifiers as required. This information is crucial for accurate processing.
Next, complete the Provider Contact Information. Fill in your contact name, title, telephone number, and email address. This ensures that you can be reached for any clarifications regarding your submission.
Proceed to the Financial Institution Information section. Here, enter your financial institution's name and address along with the *Routing Number* and *Account Number*. Select whether it’s a checking or savings account.
Finally, review the Authorization for Setup section. Sign electronically where indicated and provide the date of submission. Double-check all entries for accuracy before submitting.

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