TEXAS DEPARTMENT OF CRIMINAL JUSTICE Commissary & …
TEXAS DEPARTMENT OF CRIMINAL JUSTICE Commissary & Trust Fund Department
P.O. Box 629, Huntsville, TX 77342
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS) TO AN INMATE ACCOUNT
I authorize the Texas Department of Criminal Justice, Inmate Trust Fund, to debit my
checking account each month in the amount of $____________.00, for credit to the
following Inmate's account:
(Must be a whole dollar amount)
Inmate Name: ________________________ Inmate TDCJ #: ______________________ The funds will come from the following account: Name on Account: _______________________________________________ Bank Name: _____________________________________________________ Bank Address: ___________________________________________________
___________________________________________________ Checking Account #: _____________________________________________
**MUST ALSO INCLUDE A VOIDED CHECK**
Authorized Signature: _____________________________________________ Date: _________________ Daytime Phone #: ________________________ **Your checking account will be debited ON OR AROUND THE 5TH of each month. The funds will then be credited to the inmate's account ON OR AROUND THE 10TH of the month.
**You must be on the inmate APPROVED visitation or telephone list to make a deposit. If you are not on either list, you will be notified and your request for automatic deposits denied. **This authority is to remain in full force until TDCJ has received notice in writing from the account holder to cancel this monthly transaction from occurring.
REV 2020
ITF USE ONLY: Entered: ___________________ Verified: __________________
TF:
BK:
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