Form PSRS-116 at a glance
What it is: Form PSRS-116 is the Authorization for Direct Deposit - Electronic Transfer of Monthly Benefit.
Who signs: The payee must complete this form.
A filled-in Form PSRS-116 example: a retired teacher sets up direct deposit
How to fill out Form PSRS-116, box by box
Payee Name, SSN or PSERS ID and Date of Birth
Enter the Payee Name, the SSN or PSERS ID and the Date of Birth.
Which monthly pension account(s) this affects
Check all appropriate boxes for the monthly pension account(s) this affects: My retirement benefit, Benefit I receive as a survivor annuitant/beneficiary, Divorce benefit.
Financial institution and Depositor Account Number
Enter the Depositor Account Number, the Name of Financial Institution, the Telephone Number of Financial Institution (include area code), the Address of Financial Institution, the City, the State, the ZIP Code and the +4 (Optional).
Routing Number and Account Type to be Credited
Enter the Routing Number: it should be the first 9 digits of the number at the bottom left on your check.
If you are unsure which numbers to use, please contact your financial institution to clarify the appropriate information.
Under Account Type to be Credited, check one: Checking or Savings.
More rules for Form PSRS-116
You authorize and request PSERS to direct the net amount of your monthly benefit for electronic deposit to the financial institution and account number you indicate.
Type all entries or print them legibly in black ink.
Notify PSERS sixty (60) days prior to the effective date of the change if you wish to change the designated financial institution or account to which your net pay is to be deposited.
The authorization will remain in effect until you give written notice of its termination to PSERS in such time and in such manner as to allow PSERS a reasonable opportunity to act upon it.
This form supersedes all previous electronic transfer requests and revokes all prior payment arrangements you may have made with PSERS.
Common questions about Form PSRS-116
Who signs it?
The payee signs: print this form, sign and date it, and return it to PSERS.
Sources
[1] Form PSRS-116 (04/2020), Authorization for Direct Deposit - Electronic Transfer of Monthly Benefit, Pennsylvania Public School Employees' Retirement System (the Official source link on this page).