Aflac Direct Deposit Online is a service that allows you to have your Aflac payments deposited directly into your checking or savings account. This service is available to all Aflac policyholders and can be used to pay both premiums and claims. With Direct Deposit, you can avoid the hassle of writing a check each month, and your money will be available to you as soon as it is deposited into your account. To enroll in this service, simply fill out the form on our website and we will take care of the rest. Please note that there is a small fee associated with this service. For more information, please visit our website or contact us at (800) 995-2372.
This information will allow you to understand better the details of the aflac direct deposit online before you start filling it out.
Question | Answer |
---|---|
Form Name | Aflac Direct Deposit Online |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | aflac direct deposit claim form, aflacgroup com claim forms, direct deposit form from aflac, aflac direct deposit for claims benefits |
Ge n e r a l Accou n t Tr a n sa ct ion & D ir e ct D e posit Au t h or iza t ion
for AFL St ock Pla n Liqu ida t ion s For m
N a m e & Ad dr e ss a s Sh ow n on Accou n t : |
La st Fou r D igit s of Socia l Se cu r it y or Ta x I D N o. : _ _ _ _ _ _ _ _ |
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Accou n t N u m be r : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
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D a y t im e ph on e n u m be r : ___________________________________ |
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PARTI AL W I TH D RAW AL – CON TI N UE D I V I D EN D REI N V ESTM EN T SELECTI ON S:
□Issue Stock Certificate for _______________________ Whole Shares
□ Sell |
_______________________ Whole Shares |
____________________________________ |
Shareholder Signature |
FULL W I TH D RAW AL – TERM I N ATE D I V I D EN D REI N V ESTM EN T, BAN K D RAFT AN D D ED UCTI ON S SELECTI ON S:
□Issue stock certificate for whole shares and sell fractional share
□ Sell all plan shares |
____________________________________ |
Shareholder Signature |
( You r f in a n cia l in st it u t ion m u st b e a m e m be r of t h e Au t om a t e d Cle a r in g H ou se ( ACH ) n e t w or k . )
Aflac Incorporated (the Company) is authorized to deposit the proceeds from the liquidation of my shares held in the AFL Stock Plan by electronic funds transfer to the financial institution account indicated by the A T T A CH E D V OID E D D O CU M E N T . The Company is authorized to initiate corrections to any amounts transferred in error and any claim against the Company or the financial institution involved is waived with respect to the operation of this service. The Company and the financial institution reserve the right to terminate this service at any time.
Th is in f or m a t ion w ill n ot be m a in t a in e d on y ou r a ccou n t . I t w ill be r e qu ir e d e a ch t im e y ou r e qu e st a dir e ct de p osit of fu n ds fr om a sa le of st ock fr om y ou r AFL St ock Pla n .
N OTE: Checks and/or deposit slips from financial institutions such as sa vin g s & loa n s, t r u st ba n k s, cr e d it u n ion s, and fe de r a l sa vin g s ba n k s do not always contain the correct information for ACH deposit. Please verify with your financial institution that the bank routing number and the bank account number shown on your attached voided document are the correct numbers to be used with the ACH Network.
In cor r e ct in for m a t ion w ill de la y t h e r e ce ipt of y ou r fu n ds.
□Checking account – At t a ch a V oide d Ch e ck
□Savings account – At t a ch a V oide d D e posit Slip
You r n e t pr oce e ds w ill be se n t t o t h e fin a n cia l in st it u t ion t h a t you spe cifie d 3 bu sin e ss da ys a ft e r t h e t r a de da t e . Be ca u se t h e fu n ds go t o t h e Fe de r a l Re se r ve for pr oce ssin g, ple a se a llow a n a ddit ion a l 1 – 2 bu sin e ss da ys for t h e ba n k t o cr e dit t h e fu n ds t o you r a ccou n t .
_______________________________________________________________ |
________________________________________________________ |
Bank routing number (ABA) if different from number on Voided Check |
Signature of bank account holder |
______________________________________________________________________________________________________________________________
N ot a r iz a t ion of Sh a r e h olde r Sign a t u r e ( s)
Notarized signatures of ALL SH AREH OLD ERS are required I F the name(s) on the financial institution account to receive funds is N OT EX ACTLY the same as the name(s) on your Aflac Incorporated stock account.
_____________________________________ |
____________________________________ |
Shareholder Signature |
Shareholder Signature |
Subscribed and sworn to before me |
Subscribed and sworn before me |
__________________________________________ |
_________________________________________ |
this ______day of ______________, 20__________ |
this _______day of _____________, 20_________ |
__________________________________________ |
_________________________________________ |
Notary Public (seal) |
Notary Public (seal) |
My commission expires:_______________________ |
My commission expires:______________________ |
FAX TH I S COM PLETED FORM TO SH AREH OLD ER SERV I CES 7 0 6 . 5 9 6 . 3 4 8 8