FACTS Direct Deposit Setup - West Virginia State Auditor39s Office - linkccrr 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Provider Number and Provider Name in the designated fields. Ensure that all required fields marked with an asterisk (*) are filled out accurately.
3. Fill in your Address, City, State, Telephone Number, Zip Code, and Contact Name. Double-check for any typos to avoid processing delays.
4. In the ACCOUNT INFORMATION section, provide the Financial Institution Name and Routing Number. Select whether you have a Checking or Savings account and enter your Account Number.
5. Attach a Voided Check or a letter from your financial institution as specified. This is crucial for processing your direct deposit setup.
6. Review the authorization statement carefully before signing. Ensure you print your name, date, and title where indicated.
7. Once completed, save your document and submit it via mail or fax to the West Virginia State Auditor's Office as instructed at the bottom of the form.

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