Direct Deposit / Automatic Payment Information Form

A fast and convenient way to manage your everyday financial transactions – and it’s free!
Benefits To You
•  Convenient – Your money is deposited automatically for you, even when you are ill, on vacation or too busy to get to the bank. Your check is
deposited electronically into your Wells Fargo account.
•  Fast – You have immediate access to your money on the day of deposit.
•  Safe – Never worry about checks getting lost, delayed or stolen.
• Automatic saving – Watch your savings grow when you have at least part of your pay directed to savings.
• Automatic Payment – You can also use the routing number (RTN) and account number to set up automatic payment for your recurring bills from
your checking account. Prepaid cards are not eligible for Automatic Payments. See Terms and Conditions of your card for more information.

Three Easy Steps to Set up Direct Deposit or Automatic Payments

Step 1. Gather Account Information
You must provide your information about the account where the money will be deposited or withdrawn.

Customer Name If the account information to the left is not completed, use the following information:
FLORIDA AIR TRANSPORT, INC. For Direct Deposit and Automatic Payment For Direct Deposit
__________________________________ through Checking into Prepaid Card or Savings
Routing Number (RTN) (9 digits) Use information found on your checks
For your prepaid card or
{{OC:ADO:Account RTN CHK}} SAMPLE CHECK 0101
savings account number, check your
DATE
bank statement or account documents
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PAY TO THE ORDER OF $ provided at account opening.
Account Number DOLLARS
Contact Wells Fargo Phone BankSM
(maximum 13 digits – include leading zeros at 1-800-TO-WELLS
– do not include check number): MEMO
(1-800-869-3557) for the correct
Routing Number (RTN).
{{OC:ADO:Account RTN CHK}} A123456789A 0123456789C 0101
Please note, Wells Fargo cannot
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provide your account number
Routing Account Check
Type of Account (Check one): Number Number Number over the phone.

✔ Checking/Prepaid Card
Note: You can also find your Account Number
c c Savings on your statement or on the account documents
provided at account opening.

Step 2. Contact Your Employer or Payor

Use the table below to find the correct contact to learn if your payor offers direct deposit services and to provide your account information.
Your payor may need you to complete a form or provide a voided check to process your request.

Existing Enrollment New Enrollment

Type of Direct Deposit
• Salary/Wages
• Pension
• Dividend/Investment Income
• Social Security (SSA)
• Supplemental Security Income (SSI)
• Railroad Retirement
• Civil Service Retirement
(Office of Personal Management)
• Veterans Compensation and Pension
• Other Federal Agency Benefits
(To change the bank currently (To change your paper checks
receiving deposits electronically) to electronic deposits)
Contact your employer or other payor directly with the information on this form.
Visit a Wells Fargo Bank Branch near you
Call 1-800-772-1213 (1-800-325-0778 TTY)
or
Call 1-877-772-5772 (1-312-751-4701 TTY) for New Enrollments only, you can also visit
www.godirect.org,
Call 1-888-767-6738 (1-800-878-5707 TTY) or call Go Direct at 1-800-333-1795
Call 1-877-838-2778 (1-800-829-4833 TTY), or visit a Wells Fargo Bank Branch near you.
Contact the agency directly. Or call Go Direct at 1-800-333-1795
to get the telephone numbers of many federal agencies.

Step 3. Monitor Your Account

For direct deposit, it can take one to two months for a payor to process your request and to begin receiving electronic deposits.

Questions? Wells Fargo Phone Bank is available 24/7 at 1-800-TO-WELLS (1-800-869-3557)

© 2017 Wells Fargo Bank, N.A. All rights reserved. Member FDIC. CNS3519 FOL (Rev 02 - 02/17)