P2P Electronic Payment Enrollment
Person to Person Payments
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Payee Information (individual receiving the funds) |
*All fields are required |
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Payee’s Name |
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Payee’s Mailing Address |
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Check Number, Date, and Amount of the recent |
Check Number: |
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Date: |
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check sent to payee from FIS (if applicable) |
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Amount: |
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FIS BillPay Customer Information (payer) |
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Name and Address of the FIS billpay customer |
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who is sending the funds |
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Your E-mail Address |
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Payee Financial Institution Information |
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□ New (payee would like to start receiving electronic |
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payments) |
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Type of Request |
□ Modify (payee is currently receiving electronic payments & |
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would like to update their bank information) |
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□ Cancel (payee would no longer like to receive electronic |
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payments & would like a check sent instead) |
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Financial Institution Name |
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Financial Institution Address |
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Financial Institution Phone Number |
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Routing Transit Number |
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Bank Account Number where funds should be |
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deposited |
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Type of Account |
□ Savings (copy of savings deposit slip required) |
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Please check appropriate box and include the |
□ Checking (copy of voided check required) |
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required information listed next to account type |
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Signature ___________________________________________________________________ Date ______________
If the payee is unable to provide a voided check or savings deposit slip they should ask their financial institution to provide, on their letterhead, the required information listed in the Payee Financial Institution Information section above.
Please return completed form along with supporting bank account information to:
Fax # 414-371-5650, Attn: Payee Maintenance
Email address: payee.maintenance@fisglobal.com
Mailing address: FIS, PO Box 7236, Sioux Falls, SD 57117
If you have questions about this form, please email us at the above address or call 1-800-457-4349.
Please allow 2 business days for your request to be completed if sent by fax or email. You will be notified via the email address you have provided.
This document is protected under the trade secret and copyright laws as the property of FIS. Copying or other reproduction, modification, distribution, or any other
disclosure of this document to third parties, is strictly prohibited.
FIS Confidential Document