Form Sers 123 PDF Details

Form Sers 123 is an important form that must be filed in order to establish a new business. This form can be filed with the state or local government, and it is used to provide basic information about the company. The information on this form will help the government determine what regulations and taxes apply to the business. Filling out this form correctly is critical for setting up your business correctly. Make sure to consult with an attorney or tax professional if you have any questions about how to complete this form.

Before you decide to fill out form sers 123, you should find out more concerning the type of form you'll work with.

Form NameForm Sers 123
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namespa sers payments form, sers pa gov, pa sers 123 form, sers direct deposit form

Form Preview Example



Complete Part I. Attach a voided check for the account type selected in the payee agreement section. You may attach a voided check for a savings account if the savings account number is the same as your checking account number. If you do not attach a voided check, your financial institution must complete Part II. Send the completed form to the address below.

SERS will enter the effective date of this direct deposit instruction in the space provided and send you a copy. Your first payment after the effective date will be by check, mailed to your address on record, and a test transaction will be sent to your financial institution to ensure that everything works correctly. Once confirmed, your next payment will be deposited into your account. Monthly pension payments are deposited on the last working day of each month.


Payee Full Name (First, MI, Last)

Payee SSN

Street Address


City, State, Zip

Payee Type (Check one)









Member SSN (if Payee is not a SERS member)



SERS Member






Alternate Payee










































Action to be taken (Check all that apply)









Start Direct Deposit


Change Account Number



Change Financial Institution















Account Type (Check one - if an account type is not selected, the benefit cannot be processed.)


This change will be effective __________



Checking (voided check must be attached)

































I hereby authorize and request the Pennsylvania State Employees’ Retirement System (SERS) to direct my monthly pension payment to my account indicated in Part II below, and I further authorize the financial institution to credit the same account without responsibility for correctness of such amount. I hereby revoke all prior payment arrangements with SERS.

This authorization will remain in effect until I give written notice of its termination to SERS in such time and in such manner as to allow SERS a reasonable opportunity to act upon it. If I wish to change these instructions, I agree to notify SERS at least 60 days prior to the effective date of such change.

Payee’s Signature


PAYEE - STOP HERE! (To deposit into a savings account, have your financial institution complete the remainder of this form.)



ACH Routing Number





Account Number





















Financial Institution



































Street Address

















City, State, Zip






In consideration of SERS making payments in accordance with this authorization without requiring other proof that the payee is alive on the date which such payment falls due, we hereby agree to repay, refund and/or reimburse to SERS, on demand, the amount of payments made to and received by us, the due date of which is after the date of death of the payee, to the extent that funds representing such payments remain on deposit with this financial institution at the time of certification of payee’s death by SERS, to this financial institution.

Authorized Signature

Direct Deposit of Pension Payments | SERS 123 | Rev: 11/1/2021

30 North 3rd Street, Suite 150 | Harrisburg PA 17101 | 1.800.633.5461 |

How to Edit Form Sers 123 Online for Free

Our finest programmers worked hard to implement the PDF editor we are now happy to deliver to you. This application helps you simply prepare pa sers deposit and can save valuable time. You just need to comply with this particular procedure.

Step 1: Choose the button "Get Form Here" on the webpage and select it.

Step 2: Now you are on the form editing page. You can edit, add content, highlight certain words or phrases, insert crosses or checks, and include images.

Fill out the pa s, ers deposit PDF and type in the material for each segment:

stage 1 to writing sers pa gov

Step 3: Select the Done button to save your file. Now it is ready for upload to your electronic device.

Step 4: You could make duplicates of the form toavoid any type of potential complications. You should not worry, we cannot distribute or track your details.

Please rate Form Sers 123

1 Votes
If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .