Direct Deposit: Enrollment Form
Contact Information
Last, First and Middle Initial (or Company Name) |
Owner Number/SSN |
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Address, City, St, Zip |
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Email Address (required for check statement notification) |
Phone Number |
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Authorization
With my signature below, I confirm that I am a revenue interest owner or an authorized representative. I agree that the terms and conditions of all agreements with A adarko Petroleu Corporatio a d/or its su sidiaries Payor o er i g ethod of ti i g of pay e ts shall e a e ded as provided herein. Payor assumes
no responsibility for any loss initiated by errors, omission or delays caused by my depository bank. Payor assumes no responsibility for fees or deductions made by my depository bank. I agree to hold Payor harmless and indemnify Payor from and against all liabilities, claims, losses, costs, expenses and damages of any kind including direct, indirect, consequential and punitive asserted against Payor directly or indirectly from or arising out of the electronic transfer of funds contemplated by this enrollment form. I hereby authorize and request Anadarko Petroleum Corporation to make payments via electronic transfer into the referenced account and statement notification to be electronically emailed to the email address above upon account activation. I have read and agree to the terms and conditions in the attached direct deposit information sheet.
Signature is required.
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Printed name(s) |
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Signature(s) |
Date |
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Bank Information
Complete the banking information below or include a pre-printed voided check or savings deposit slip (PDF or scanned copy is acceptable). Savings deposit slips do not always contain the correct routing number. Please confirm ABA number with your bank before submitting.
Bank Institution Name
ABA or ACH Routing Number |
Account Number |
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Account Type: Checking, Savings, Money Market |
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Return To
Anadarko Petroleum Corporation |
Note: Anadarko Petroleum Corporation maintains several subsidiaries. |
Timberloch – BA Group |
The return address provided on this form is acceptable for all |
P.O. Box 1330 |
subsidiaries. |
Houston, TX 77251-9874
Fax: (832)636-5048
Email: Business_Associates_Requests@anadarko.com
A scanned version (PDF) of your signed form with bank information is acceptable.
Direct Deposit/ACH Interest Payment Information Sheet
When will the funds be deposited?
Funds transfers will be initiated via Automated Clearing House (ACH) electronic transfer on the day before checks are mailed. The transfer is expected to take place in less than 24 hours. This will provide more immediate access to your funds and result in a more convenient and secure transaction.
What will happen to the property-level detail that normally comes with my check?
If you elect to enroll in the ACH program, you will be automatically enrolled in the "Stop Paper Detail" service provided to you at no cost through the secure Anadarko Owner Relations Website. To activate your account, login to the Anadarko Owner Relations Website at https://connect.oildex.com/apc/ using your Anadarko Owner Number and your initial temporary password which is the last six digits of your Social Security Number or tax ID. Your revenue payment and property-level details are immediately available for online viewing at the time of the deposit into your account. Once your account is activated, you will receive an email notification when a new statement is available.
How do I elect to receive the property-level details via e-mail?
If you do not want to login to your account every month, you can elect to have your statements emailed directly to you. To select this option, first, login to the Anadarko Owner Relations Website at https://connect.oildex.com/apc/ using your Anadarko Owner Number and password. Your initial temporary password is the last six digits of your Social Security Number or tax ID. Then, click on the "My Profile" tab; click on "Change Email Address ... ": check both "Send email notification ... " AND "Send data .... ": and be sure
to provide a password for the data file. For assistance, please contact Oildex technical support at support@oildex.com.
Can I direct funds to more than one account?
Deposits can only be sent to one account.
What type of accounts can be used for Direct Deposit?
Any account that accepts ACH transfers can be used in the program (this includes money market accounts). If you are unsure as to whether your bank or investment firm is set up to accept ACH transfers, please contact your institution prior to returning your enrollment form. If we encounter difficulty during the setup and testing process, you will be notified using the contact information you have provided. This may delay the start date for you to receive electronic deposits.
What happens if I need to change the deposit account at a later date?
Changes to your banking information and contact information can be made at any time in writing. Please remember to notify us thirty (30) days before closing or changing an account that you are using for electronic deposits. If changes are not communicated before an ACH transfer is declined by your bank, it will cause a delay in the receipt of your funds.
How soon will the electronic deposits start after you receive my enrollment form?
Depending on the date your form is received and processed, Direct Deposit will begin either at the end of the current month or the following month. (If Direct Deposit does not begin until the following month, a check will be issued for the current month.)
Will there be any changes to year-end reporting?
There will be no change in year-end reporting. You will receive information on IRS Form 1099 which will be mailed to you and also available via the Anadarko Owner Relations Website at https://connect.oildex.com/apc/
Who is my contact for questions regarding Direct Deposit?
For further information, please contact the Customer Relations department via phone 1-800-359-1692 or email
Owner.Relations@Anadarko.com
