DIRECT DEPOSIT SIGN-UP FORM
DIRECT DEPOSIT SIGN-UP FORM (SF 1199A)
SECTION 1
A. Enter information as it applies to you. List permanent address.
B. Enter names of all persons entitled to payment. Include yourself.
C. Enter your Social Security number.
D. Check the box that applies to the type of account into which the money will be deposited.
E. Enter either the number of the account into which the money will be deposited.
F. Check “Other” and enter “Stipend” on the line.
G. Leave this blank.
PAYEE/JOINT PAYEE CERTIFICATION: Sign and date.
JOINT ACCOUNT HOLDERS’ CERTIFICATION: Leave this blank, unless it is a joint account, then the joint account holder signs and dates.
SECTION 2
Do not enter any information.
SECTION 3
Take this form to your bank to have them enter the SECTION 3 information. If a checking account, bring a blank check from the account named in SECTION 1 to the bank to assist in filling out the information.
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