Navigating the details of financial adjustments, especially when it involves institutional processes, requires clear and accurate forms. The 05305 form, issued by the Alaska Department of Revenue Permanent Fund Dividend Division, stands as a critical document for individuals who are looking to make changes to their direct deposit information related to the Permanent Fund Dividend (PFD). This form is vital after the submission of a PFD application when there's a need to add, change, or withdraw direct deposit details. Designed to facilitate updates to the current year's records only, it demands precise and complete information to avoid processing delays. Beyond the primary function of updating direct deposit information, the form also accommodates address changes through a separate request mechanism, ensuring individuals' records remain up-to-date. It caters to various scenarios, whether it's adding new financial information, changing existing details, or ceasing direct deposit arrangements altogether. This adaptability is further exemplified in its requirements, necessitating details of the account holder's name, social security number, date of birth, and specifics about the financial institution. For those changing or withdrawing information, historical bank details are required to safeguard against unauthorized changes. Accompanied by stringent identity verification processes, including notarization or personal verification at PFD offices, the form underscores the division's commitment to security. With instructions that spell out the procedural steps and requisite information, including the distinction between checking and savings accounts, it ensures applicants are well-guided. This form is more than just paperwork; it's a pivotal tool in managing one's financial link with the Alaska Permanent Fund Dividend, embodying both flexibility and a stringent security framework.
| Question | Answer |
|---|---|
| Form Name | Form 05305 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | pfd application, pfd printable form, permanent fund application 2020, pfd application form 2020 |
20305 |
Alaska Department of Revenue |
|
|
|
Permanent Fund Dividend Division |
|
Direct Deposit Form |
Use this form after you have submitted your PFD application and want to add, change, or withdraw your direct deposit information. The PFD Division will apply this direct deposit change to current year records only. Requests with incomplete or incorrect information will not be processed.
Has your address changed since you applied for the dividend? If so, please submit our Address Change Form available at our website at www.pfd.alaska.gov, or at one of the Division offices.
Whose Direct Deposit information are you changing? Include your name if changing your information
First Name
MI
Last Name
Last four digits of SSN Date of Birth (MM/DD/YY)
ALN- Division Use Only
First Name
MI
Last Name
Last four digits of SSN Date of Birth (MM/DD/YY)
ALN- Division Use Only
First Name
MI
Last Name
Last four digits of SSN Date of Birth (MM/DD/YY)
ALN- Division Use Only
First Name
MI
Last Name
Last four digits of SSN Date of Birth (MM/DD/YY)
ALN- Division Use Only
Mark one of the following and follow the directions carefully
ADD
If adding information, provide new financial information
CHANGE If changing information provide new information and information currently on record
WITHDRAW If withdrawing from Direct Deposit, provide information currently on record
Provide NEW Financial Institution Information when Adding or Changing
Enter NEW Financial Institution Name |
|
|
|
|
|
|
|
|
|
|
|
Financial Institution Routing Number |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Check the appropriate box to indicate if the account is a |
Checking |
|
Savings |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
OR |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
checking or savings account. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Account Number |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Enter the account number. (See instructions on the back of |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
this form) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Child's |
|
Sponsor's |
|
|
Both |
|||||||||||||||
If adding or changing a child's account, check the |
|
|
|
|||||||||||||||||
|
|
|
OR |
|
|
OR |
|
|
|
|
|
|
|
|
|
|
|
|||
appropriate box to indicate whose name is on the account. |
|
|
|
|
|
|
|
|
||||||||||||
Provide Financial Information currently on record when Changing or Withdrawing
NOTE: For security purposes, the information that is currently on the record is required. If unsure of the bank information currently on the record, provide identification at one of PFD's offices OR have this form notarized. See back.
Previous Financial Institution Name |
|
Previous Financial Institution Account Number |
||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Signature: I certify that I am authorized to change the finanical institution information of the person(s) listed above. If applicant is a child, the adult who sponsored the application must sign. If signing on behalf of another adult, provide proof of legal authority to sign on their behalf. Unauthorized requests will not be processed.
SIGNATURE IS REQUIRED FOR ALL ADULTS 18 AND OVER
Phone Number
Adult Signature |
Date |
Daytime Telephone Number |
Printed name of the person who signed |
Social Security Number |
Date of Birth |
Adult Signature |
Date |
Daytime Telephone Number |
Printed name of the person who signed |
Social Security Number |
Date of Birth |
Email Address |
|
|
Send this completed form to: Permanent Fund Dividend Division, PO Box 110462, Juneau, AK
Phone (907) |
20305 |
|
Confidential
Form 20305 (Rev. 12/19) |
www.pfd.alaska.gov |
Adult or Sponsor’s Name (First, Last) |
20306 |
|
Direct Deposit Instructions
The routing number is always the first set of 9 digits on the bottom of your check starting from the left. If you are unsure of the routing number, contact your financial institution directly.
The account number is typically the second series of digits on the bottom of your check starting from the left. Enter the account number starting on the left side, without dashes or other characters.
For example, if your account number is
Enter the Account Number
Start account number from this side
1 2 3 4 5 6 7 8 9 0
Requests with incomplete or incorrect information will not be processed.
If you are unsure of the account or account number, contact your financial institution.
Notary |
Adult one |
Alaska Postmasters may provide notary requirements. (Name, title, cancellation stamp, location and date) |
State of ____________________________ |
|
|
___________________________________, being by me duly sworn, personally appeared before me and signed this document.
Name of Requestor
___________________________________
Signature of Requestor
Subscribed and sworn before me by _________________________________________ this ________________ day of
Name of Notary Public
________________, 20_____.
|
|
Notary Seal |
Notary Comission expires: _______________ |
__________________________________________________ |
|
|
|
Signature of Notary Public |
|
|
|
Notary |
Adult two |
Alaska Postmasters may provide notary requirements. (Name, title, cancellation stamp, location and date) |
|
|
|
State of ____________________________ |
|
|
___________________________________, being by me duly sworn, personally appeared before me and signed this document.
Name of Requestor
___________________________________
Signature of Requestor
Subscribed and sworn before me by _________________________________________ this ________________ day of
|
Name of Notary Public |
Notary Seal |
________________, 20_____. |
|
|
Notary Comission expires: _______________ |
__________________________________________________ |
|
|
Signature of Notary Public |
|
PFD Division Representa ve |
|
|
|
||
_______________________________________ appeared before me with picture iden fica on. |
||
Name of Requestor(s) |
|
|
_______________________________________________ |
___________________________ |
|
Printed name of PFD Division Representative |
|
Date |
20306