San Diego County Credit Union Fillable Forms
OMB No. 1510-0007 TEST Standard Form 1199A (August 2005) Prescribed by Treasury Department Treasury Department Cir. 1076 Or call Go Direct at 1 (800) 333-1795 to sign up today.* SM DIRECTIONS Please refer to the information on the reverse side before completing this form. You must complete a separate form for each type of federal payment (social security, supplemental security income, veterans' benefits, etc.). You are responsible for keeping the paying agency informed of any name or address changes MoreHOLDERS on the back of this form. SIGNATURE. DATE. SM. REPRESENTATIVE PAYEE? if yes, enter name at right. ** You may also attach a voided personal Less
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