SafeSpend CardSM Direct Deposit Form
Benefits
•Convenient — There is no need to fit in time to cash checks into your busy schedule.
•Fast — You have immediate access to your money at the time of the deposit.
•Safe — Never worry about checks getting lost, delayed or stolen.
•Automatic Payment — Your money is automatically deposited onto your SafeSpend Card.
How to Set up Direct Deposit
Complete and SIGN this form then give it to your employer or other payor — or —
Use the table below to identify common payors who typically only accept government form 1199a.
To whom it may concern — Please begin making payment by direct deposit to my BBVA Compass account.
__________________________________________________________________________________________________________________________________________________________________________________________________
NAME (PLEASE PRINT)
__________________________________________________________________________________________________________________________________________________________________________________________________
ADDRESS
_________________________________________________________________________________________________________________________________________________________________________________________________
|
CITY |
STATE |
ZIP |
Date ___________ /___________ /___________ |
Phone ___________________________________________________________________________________________________ Day / Evening (circle one) |
__________________________________________________________________________________________________________________________________________________________________________________________________
SIGNATURE
|
0 |
6 |
2 |
0 |
0 |
1 |
1 |
8 |
6 |
|
Name and address |
|
Routing Number _____ |
_____ |
_____ |
_____ |
|
_____ |
_____ |
_____ _____ |
|
of financial institution: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Account Number _____ |
_____ |
_____ |
_____ _____ |
_____ _____ _____ _____ |
_____ _____ _____ |
_____ _____ _____ _____ _____ |
Compass Bank |
|
15 South 20th Street |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(To get your 17-digit account number simply login to your account and go to the account activity screen) |
Birmingham, AL 35233 |
|
|
|
|
This is not your card number |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Employed by or receive benefits from a U.S. government agency? |
|
|
|
Direct Deposit |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
100% of my pay |
|
|
|
|
|
Type of Direct Deposit |
|
Contact Information for that Agency |
|
|
Other Amount |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
• |
Social Security (SSA) |
|
Call 1-800-772-1213 (1-800-325-0778 TTY) |
|
|
|
|
|
|
|
|
|
|
|
|
$ |
|
|
|
or |
|
|
• Supplemental Security Income (SSI) |
www.socialsecurity.gov |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
% |
|
|
• |
Civil Service Retirement |
Call 1-888-767-6738 (1-800-878-5707 TTY) |
|
|
|
|
|
|
|
(Ofice of Personal Management) |
www.servicesonline.opm.gov |
|
|
Ability to specify amount or percent |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
• Veterans Compensation and Pension |
Call 1-877-838-2778 (1-800-829-4833 TTY) |
|
|
of pay may not be available |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
www.va.gov |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Your payor may need you to complete a separate form in order to process your request. Your payor should |
|
|
|
|
|
|
|
provide you with a copy of your completed authorization. |
|
|
BBVA Compass is a trade name of Compass Bank, Member FDIC.
Rev 5/2011
