Wells Form Direct Deposit – Fill Out and Use

Routing Number (RTN) (9 digits)

If the account information to the left is not completed, use the following information:

For Direct Deposit and Automatic Payment

{{OC:ADO:Account RTN CHK}}

For Direct Deposit

through Checking

into Prepaid Card or Savings

___ ___ ___ ___ ___ ___ ___ ___ ___

Use information found on your checks

For your prepaid card or

SAMPLE CHECK

0101

Account Number

savings account number, check your

DATE

bank statement or account documents

$

(maximum 13 digits – include leading zeros –

PAY TO THE ORDER OF

provided at account opening.

do not include check number):

DOLLARS

Contact Wells Fargo Phone BankSM

{{OC:ADO:Account RTN CHK}}

at 1-800-TO-WELLS

MEMO

(1-800-869-3557) for the correct

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

Routing Number (RTN).

123456789

0123456789

0101

Type of Account (Check one):

Please note, Wells Fargo cannot

Routing

Account

Check

provide your account number

c Checking/Prepaid Card

c Savings

Number

Number

Number

over the phone.

Note: You can also find your Account Number

on your statement or on the account documents

provided at account opening.

Type of Direct Deposit

Existing Enrollment

New Enrollment

(To change the bank currently

(To change your paper checks

receiving deposits electronically)

to electronic deposits)

•

Salary/Wages

•

Pension

Contact your employer or other payor directly with the information on this form.

•

Dividend/Investment Income

•

Social Security (SSA)

Call 1-800-772-1213 (1-800-325-0778 TTY)

Visit a Wells Fargo Bank Store near you

•

Supplemental Security Income (SSI)

or

•

Railroad Retirement

Call 1-877-772-5772 (1-312-751-4701 TTY)

for New Enrollments only, you can also visit

www.godirect.org,

•

Civil Service Retirement

Call 1-888-767-6738 (1-800-878-5707 TTY)

(Office of Personal Management)

or call Go Direct at 1-800-333-1795

•

Veterans Compensation and Pension

Call 1-877-838-2778 (1-800-829-4833 TTY), or visit a Wells Fargo Bank Store near you.

•

Other Federal Agency Benefits

Contact the agency directly. Or call Go Direct at 1-800-333-1795

to get the telephone numbers of many federal agencies.

Step 3. Monitor Your Account

© 2013 Wells Fargo Bank, N.A. All rights reserved.

CNS3519 FOL (Rev00-5/13)