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15021 Katy Freeway, Suite 400

15021 Katy Freeway, Suite 400 2025

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The document is an ACH/Direct Deposit Enrollment Form from Alta Mesa Services, LP, allowing mineral interest owners to authorize electronic funds transfers for their royalty payments. It includes sections for personal and banking information, consent for electronic payments, and terms regarding changes or cancellations of the authorization. The form emphasizes the need for security in submission and requires a voided check or bank verification.

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Click ‘Get Form’ to open it in the editor.
Begin by selecting the request type: either 'New Application' or 'Change Existing Setup'.
Fill in your Owner Name, Phone, Owner Number, and Fax in the designated fields.
Provide your complete Address, including City, State, and Zip code.
Enter your Social Security Number or TIN accurately.
If applicable, check the box for 'Cancel Direct Deposit'.
Input your E-mail Address for communication purposes.
Attach a voided check or a letter from your bank verifying your banking information as instructed.
Complete the Bank Routing (ABA) Number and Bank Account Number fields.
Select the Account Type by checking either 'Checking' or 'Savings'.
Finally, sign and date the form where indicated to authorize the direct deposit setup.

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2018	4.5 Satisfied (51 Votes)
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