аЯрЁБс>ўџ GIўџџџFџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС3  ПкbjbjOЃOЃ 0-Щ-ЩY џџџџџџ]"""""""66668n,š$6U$,ЪЬЬЬЬЋЋœGPК#М#М#М#М#М#М#$%єu'р#u"—ЇЋ——р# ""ЬЬлЪ   —†"Ь"ЬК#66""""—К# Ž ™д"Ь""К#ЬО аЛ=Ѓ+Ф66ю # State of Delaware  FORMCHECKBOX  New Address Pensioner s Direct Deposit Authorization Form NAME:  FORMTEXT       SSN:  FORMTEXT ###-##-#### EMPLOYEE ID#  FORMTEXT       ADDRESS:  FORMTEXT       CITY:  FORMTEXT       STATE:  FORMTEXT    ZIP+4  FORMTEXT       In accordance with 70 Del. Laws, C118, recipients of State retirement payments are required to receive such payments by electronic funds transfer. Hence, I understand my monthly benefit amount will be direct deposited to the account(s) designated below so that the funds are available to me on the last working day of each month. I further understand that the Pension Office will mail a notice of the amount deposited in my account(s). To have your net Pension amount go to ONE account or to have the majority of your monthly Pension amount go to a primary account (with specific dollar amounts going to additional accounts listed below), complete the following:  FORMCHECKBOX  Deposit Net Monthly Pension CHECK ACCOUNT TYPE  FORMCHECKBOX  Checking  FORMCHECKBOX  Savings Amount into this account. Routing #:  FORMTEXT       Account #:  FORMTEXT       OR Bank Name  FORMTEXT        FORMCHECKBOX  Use this account as primary with additional monies going Bank Address  FORMTEXT       to accounts listed below. If you are using this form to change an existing direct deposit to a primary account and wish to have ALL other additional deposits (i.e. savings account deposits and/or credit union deposits) remain the same, Please check one  FORMCHECKBOX  Continue additional deposits OR  FORMCHECKBOX  Stop additional deposits and deposit all monies into the above account To have a specific dollar amount go to additional banks or credit unions, complete as many of the following as necessary: Deposit the Following $ Amount:  FORMTEXT       CHECK ACCOUNT TYPE  FORMCHECKBOX  Checking  FORMCHECKBOX  Savings Routing #:  FORMTEXT       Account #:  FORMTEXT       Bank Name  FORMTEXT       Bank Address  FORMTEXT       Deposit the Following $ Amount:  FORMTEXT       CHECK ACCOUNT TYPE  FORMCHECKBOX  Checking  FORMCHECKBOX  Savings Routing #:  FORMTEXT       Account #:  FORMTEXT       Bank Name  FORMTEXT       Bank Address  FORMTEXT       I understand that I may change the above authorization(s) at any time by notifying the Office of Pensions in writing. ______________________________________________ ___________________________ _____________________ Signature of Pensioner or Power of Attorney Telephone Number Date Return form to the Office of Pensions, McArdle Building, 860 Silver Lake Blvd., Suite 1, Dover, DE 19904-2402 or fax completed form to (302) 739-6129. If you have any questions, call the Pension Office at (302) 739-4208 or (800) 722-7300. A COPY OF A VOIDED CHECK, SAVINGS PASSBOOK, OR BANK STATEMENT SHOWING THE ACCOUNT NUMBER FOR EACH ACCOUNT MUST ACCOMPANY THIS FORM. NOTE: If you move and the “Direct Deposit Advisory Notice” or other mailings are returned undeliverable by the Post Office, your electronic funds transfer authorization will be terminated and the funds held until a signed change of address has been received by the Pension Office. 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