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ACHFORM03/09 rev 01/2013, 05/2015, 02/2016Automatic Deposit/Withdrawal Request Authorizes First State Bank to establish automatic (direct) deposits or withdrawals to/from your First State Bank Account.

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How to fill out automatic depositwithdrawal request

01

Obtain the automatic deposit/withdrawal request form from your bank or financial institution.

02

Fill out your personal information including your name, account number, and contact details.

03

Specify the amount you wish to automatically deposit or withdraw and the frequency of the transaction.

04

Provide your bank or financial institution with the necessary authorization to set up the automatic deposit/withdrawal.

Who needs automatic depositwithdrawal request?

01

Individuals who want to automate their regular deposits or withdrawals without having to manually initiate each transaction.

02

Businesses that have recurring payments or payroll to manage and want to streamline the process.

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What is automatic deposit/withdrawal request?

An automatic deposit/withdrawal request is a form submitted to authorize automatic transactions to be made from a bank account, such as direct deposits or recurring bill payments.

Who is required to file automatic deposit/withdrawal request?

Individuals or businesses who wish to set up automatic transactions from their bank account are required to file an automatic deposit/withdrawal request.

How to fill out automatic deposit/withdrawal request?

To fill out an automatic deposit/withdrawal request, one must provide their account information, the amount to be deposited/withdrawn, the frequency of the transaction, and any other necessary details specified by the financial institution.

What is the purpose of automatic deposit/withdrawal request?

The purpose of an automatic deposit/withdrawal request is to streamline financial transactions and ensure timely payments without the need for manual intervention each time.

What information must be reported on automatic deposit/withdrawal request?

The information required on an automatic deposit/withdrawal request typically includes the account holder's name, account number, transaction amount, frequency, and any special instructions for the transaction.

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