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Direct Deposit Authorization Form. This is a Florida form and can be use in Lake Local County.
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Tags: Direct Deposit Authorization Form, Florida Local County, Lake
Neil Kelly
Clerk of the Circuit Court • County Court • Board of County Commissioners
550 West Main Street • Post Office Box 7800 • Tavares, Florida • 32778-7800
(352) 742-4100
Clerk of the Circuit Court
DIRECT DEPOSIT
Receiving child support is now FASTER and EASIER
WHAT IS DIRECT DEPOSIT?
Direct deposit is also known as electronic funds transfer (EFT). Once authorized, your
child support payment will be deposited directly into your account.
WHY SHOULD I SIGN UP FOR DIRECT DEPOSIT?
• Eliminate potential mailing delays.
• Eliminate lost or stolen checks.
• Eliminate waiting in bank lines.
• Enjoy automatic deposits while you are on vacation, away on business, or in the
event you are ill.
HOW DO I KNOW IF I HAVE A PAYMENT?
You may call the State of Florida Disbursement Unit toll free at (877) 769-0251 if your case is a
Non-IV-D case and not contracted with the Department of Revenue. If your case is a IV-D case
and you have contracted with the Department of Revenue, you will need to call their toll free
number, (800) 226-6777. These systems tell you the date the last payment was mailed. If
using EFT, this would be the date funds were transferred to your bank. In most instances your
funds will be available within two business days of the transfer, depending on your bank’s EFT
policy.
HOW DO I GET IT STARTED?
If your case is contracted with the Department of Revenue you will need to contact their
office at 1-800-622-5437 for direct deposit options.
If you elect to use this service, please complete and return the authorization form along
with a voided check (for a checking account) or a voided deposit slip (for a savings
account).
If you do not have a voided check or deposit slip, a letter on bank letterhead signed by a
bank representative indicating your routing number, account number, and name on the
account will be required.
QUESTIONS? Call the Child Support Department at (352) 742-4140.
Revised 5/11/09
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STATE OF FLORIDA DISBURSEMENT UNIT
DIRECT DEPOSIT AUTHORIZATION FORM
_______________________________
Name (Please Print)
________________________________
Case Number
Home Phone # ___________________
Work Phone #
Bank Name:______________________
Branch:__________________________
Branch Phone #___________________
Account #________________________
__________________
I authorize the Clerk of Court/State of Florida Disbursement Unit (SDU) to make
deposits to my ____Checking ____Savings account listed above. The Clerk/SDU may
make deposits to this account until I cancel the authorization and the Clerk/SDU has
time to act on it. This request cancels any other direct deposits I have in place with the
Clerk/SDU. If funds are mistakenly deposited into my account,
I authorize the Clerk/SDU to deduct the amount of the error from my account or from my
future payments.
I agree that the Clerk/SDU will have no responsibility for personal checks written against
my account and that my account will be administered in accordance with the rules and
regulations of the Bank.
Signature:___________________________ Date__________________________
ATTACH VOIDED CHECK
OR
SAVINGS DEPOSIT SLIP HERE
Please mail or deliver completed form to
NEIL KELLY, CLERK
ATTN: CHILD SUPPORT DIVISION
550 West Main Street
P O BOX 7800
TAVARES, FL 32778-7800
Revised 5/11/09
American LegalNet, Inc.
www.FormsWorkflow.com