Get the free Direct Deposit Authorization Form - Cigna

Recurring Direct Debit Authorization Form ONLY complete if you want your premium automatically deducted from your bank account. DO NOT complete both sides of this form. Member Name: Type of Account:

How to fill out direct deposit authorization form

How to fill out direct deposit authorization form:

1. Obtain the direct deposit authorization form from your employer or financial institution.
2. Fill out your personal information, including your full name, address, and contact information.
3. Provide your bank account details, including the bank name, routing number, and account number.
4. Specify the type of account (checking or savings) and indicate whether it is an individual or joint account.
5. Sign and date the form, acknowledging your consent to authorize direct deposits into your designated account.
6. Submit the completed form to your employer or financial institution as instructed.

Who needs direct deposit authorization form?

1. Employees who wish to receive their salary or wages directly deposited into their bank account.
2. Individuals receiving benefits or payments from government agencies, such as Social Security or Medicare.
3. Recipients of recurring payments, such as pensions, annuities, or rental income, who prefer the convenience and security of direct deposit.
4. Businesses or organizations that need to authorize direct deposits for their employees or contractors.
5. Individuals who want to streamline their banking and avoid the need for physical checks or cashing paper payments.

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What is direct deposit authorization form?

A direct deposit authorization form is a document that allows an individual or organization to authorize direct deposits into their bank account.

Who is required to file direct deposit authorization form?

Any individual or organization that wishes to receive direct deposits into their bank account is required to file a direct deposit authorization form.

How to fill out direct deposit authorization form?

To fill out a direct deposit authorization form, you need to provide your bank account information, such as the account number and routing number, and sign the form to authorize the direct deposits.

What is the purpose of direct deposit authorization form?

The purpose of a direct deposit authorization form is to provide the necessary information and authorization to facilitate direct deposits into a designated bank account.

What information must be reported on direct deposit authorization form?

The direct deposit authorization form typically requires the reporting of bank account information, including the account number and routing number, as well as the individual or organization's name and contact information.