Internet Direct Deposit Application

Overview of Pages in DD

Authentication/RISA Shots

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Overview of Pages in DD
These screenshots were generated on 9/26/2008 around 4:25 p.m.

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Overview of Pages in DD

Authentication/RISA Shots

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Acknowledgement For Online Services

Page 1 of 1

Skip to Central Contenj
Social Security Online
Social Security Online Services
'i{ww .socialsecurity.gov

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Social Security logo

, _ ,

__

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Acknowledgement For Online Services
IMPORTANT: You can use this website to gain access to your personal information. If you are acting
on behalf of another person, or if you are a Representative Payee, you cannot use this online service
and should contact a Social Security representative.
Any person who knowingly and willingly makes any representation
1. that is false to obtain information from Social Security records, and/or
2. that is intended to deceive the Social Security Administration as to the true identity of the

individual,

could be punished by a fine or imprisonment, or both. The OMB control number for this form is
0960-0632; expiration date XXlXXIXXXX.
I have read and agreed to the above statement. I am the individual whose personal information I
am requesting.
( IAgree]

IExitj
If you need immediate assistance:
You may call us Monday through Friday: 7:00 AM - 7:00 PM at:

1-800-772-1213
If you are deaf or hard-of-hearing, call our toll-free TTY number:

1-800-325-0778

,0

Link to FirstGov,gov: U,S, Government portal

Need Larger Text?

PJiva9'J~Qli9' I Web_site PQlic;iQs& Qther hllPQrtant InfOlm_ation I Site Map

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Log In - Enter Your SSN And Password

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Skip to Central Contem
Social Security Online
Social Security Online Services
\Vww .socials~clJrity. ,gQY

, [!)

Social Security logo '

Log In - Enter Your SSN And Password
Please provide the following information:

Enter your Social Security number:
Enter numbers without dashes, for example, 123456789
Enter your Social Security Number: Enter numbers without dashes, for example, 123456789.

Enter your password:
Enter your password.

IExit]

[ Continue]

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About Direct Deposit

Page lof2

Skip to Central Content
Social Security Online
Start or Change Direct Deposit
wwV!.~ocialses:urity.gov

. [!J

Social Security logo .

About Direct Deposit
Social Security provides this web site for your convenience.

Limitations:
• This web site can be used to start or change direct deposit only for your own Social Security
benefits. If you are a representative payee for another person, you should contact an SSA
representative to start or change direct deposit for that person.
• It may take between 3 - 5 days for our records to update. If you login before the record is updated,
a message will inform you that the update is in process. You will be able to view and change your
information after the update period.
• This web site is not to be used by employees of financial institutions to establish direct deposit for
their customers.
• For security reasons, there are time limits for your work on each page. You will receive a warning
after 25 minutes, and you will be able to extend your time on the page. After the third warning on
a page, you must move to another page or your time will run out, and your work on that page will
be lost. If you have turned JavaScript off in your browser, you will not receive these warnings.
After spending 30 minutes on a page, you must move to another page or you will be logged out.

Do not use the Back button on your browser to move backward. Use the Prior Page button
instead.
Do not use the Enter key to move around in the form. Use the Continue button instead.

By using this web site, you agree to accept its limitations.

The Privacy Act Statement See Revised Privacy Act

Statement
The Social Security Administration is authorized to collect the information requested on this form,
including the individual claim number, under 31 USC 3322 and 31 CFR 210. The information is
confidential and is needed to prove entitlement to payments. We need this information to process
payment to the financial institution and/or its agent. Your response to this request is voluntary; however,
not providing the requested information may delay or prevent receipt of payments through the Direct
Deposit/Electronic Funds Transfer Program.
Although the information you furnish on the form is rarely used for any other purpose than stated, there
is a possibility that information may be disclosed to another person or to another governmental agency
to comply with Federal laws requiring the release of information from Social Security records. For

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About Direct Deposit

Page 2 of2

example, we may provide information in response to a request from a Congressional office or the Office
of the President.
We may also use the information you give us when we match records by computer. Matching programs
compare our records with those of other Federal, State or local government agencies. Many agencies
may use matching programs to find or prove that a person qualifies for benefits paid by the Federal
government. The law allows us to do this even if you do not agree to it.
Explanations about these and other reasons why information you provide us may be used or given out
are available in Social Security Offices. If you want to learn more about this, contact any Social Security
Office.

Paperwork Reduction Act See Revised Paperwork
Reduction Act
This information collection meets the requirements of 44 U.s.C. § 3507, as amended by section 2 of the
~erwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid
Office of Management and Budget (OMB) control number. We estimate that it will take about 10
minutes to read the instructions, gather the facts, and answer the questions. You may send comments on
our time estimate above to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401. Send only
comments relating to our time estimate to this address, not the completed form.
The OMB control number for this Direct Deposit application is 0960-0634; expiration date
XXIXXIXXXX.

1§'5itJ
[ Continue

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What You Will Need

Page 1 ofl

.skh) to G<:ntral Content
Social Security Online
Start or Change Direct Deposit
www.sQ.c:ialsecurity.gov
Fonn Approved: OMB No. 0960-0634
Expires XXlXX/XXXX

. [!]

Social Security logo

!

What You Will Need
To start or change direct deposit, you will need to have the Routing Number which identifies your bank
or financial institution and your Account Number.

Direct Deposit Checklist
If you are starting/changing direct
deposit to a ...

Iyou will need to...

!Checkin~ account

I!Have your checkbook ready

I

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1. Call your bank or credit union

Isavings account

2. Ask for the Routing Number

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IInvestment account
I

3. Have your statement or passbook with your Account
Number
l. Call your investment company
2. Ask for the Routing Number and Account Number for
direct deposit

To protect everyone's privacy, each person who wants to start or change direct deposit for Social
Security benefits must request it. For example, each spouse will need to start or change his or her direct
deposit separately.

Do you have what you need?

- 0 Do you have what you need?Yes
I Exit 1
[Prior paRe

No

Do you have what you need'll don't know

I ( Gontil"lue J

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Welcome

Page 1 of 1

Skip to Central CQrrtent

Social Security Online

Change Direct Deposit

~~ww~ociaisecurity.gov

[!]

Social Security logo :

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Welcome, ISAIAS ZAMORA
Our records show that you already have direct deposit of your Social Security benefits to:
Your current bank name: LASALLE BANK N A
The bank's routing number: 071922544
Last 4 digits of your current account: 6731
Before you start, we need to know whether you live in the United States, which includes:
•
•
•
•
•
•
•

one of the 50 states,
the District of Columbia,
Puerto Rico,
the U.S. Virgin Islands,
Guam (no APO or FPO addresses),
the Northern Mariana Islands, or
American Samoa.

Do you live in the United States?
Do you live in the United States?Yes

0 No

Are you listed as an owner or co-owner of the account where you want to deposit your
check? _Exflmpl~~f a~~~YJlL(n~:ne ..ship
Are you listed as an owner or co-owner of the account where you want to deposit your check? Yes
No
Are you listed as an owner or co-owner of the account where you want to deposit your check?
I don't know

IExit I

[ Prior Page ] ( C0!1tinue

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About Your Account

Page 1 of 1

S~inJQ Central COll1ent
Social Security Online
Start Direct Deposit
www-,-~~ialliecurity"gov

o

Social Security logo .

About Your Account

Please select the type of account where you want your direct deposit to go.

- 0 Please select the type of account where you want your direct deposit to go. Checking Account
(including money market and credit union "share draft" accounts) Checking account (including money
market and credit union "share draft" accounts)
Savings account Savings account
An account at an investment company or broker An account at an investment company or broker
Please select the type of account where you want your direct deposit to go. Other Other

IEXit]

L PriorPag~ .. ] [,~ofltinueJ

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Your Checking Account

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Skip to CelltralConten!
Social Security Online
Start Direct Deposit
wvv~v.~ocialsecurity.gov
i

. ~ Social Security logo :
-- j

Your Checking Account
Look at a check, not a deposit slip, from your account to find your Bank's Routing Number and your
Account Number. Then type them in the spaces below.

: ~ Sample check displaying routing number, account number, and check number.

!

Note: Some checks show these

_I numbers in a different order.
Check D.escription

Routing Number (9 digits)
Please enter your 9 digit routing number.

Account Number
Please enter your account number.

Important: If your account is at a credit union, investment company, or a small bank, look below your
bank's name on the check. If it says "Payable through" and shows the name of another bank, it means
your bank processes checks through a different bank. You will need to contact your bank and ask for the
correct Routing Number to use for direct deposit.

IExit I
Prior

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Your Savings Account

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Skip to Central Content
Social Security Online
Start Direct Deposit
www.socialsecurity.gov

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Social Security logo :

Your Savings Account
To identify your savings account, you will need to enter the Routing Number, which identifies your
bank or financial institution, and your Account Number.
The Routing Number is not usually shown on your passbook or account statement. If you do not have
this information, you should call your bank or financial institution to get it.

Routing Number (9 digits)
Please enter your 9 digit routing number.

Account Number
Please enter your account number.

IExitl

L.Pri()r f>;igei LSontinu~. J

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Your Investment Account

Page 1 ofl

SkitLto Central Content
Social Security Online
Start Direct Deposit
www .socialsecurity. gov

,0

1

Social Security logo

Your Investment Account
When Social Security sends a direct deposit to an investment account, it goes into a special account that
the investment company has set up for this purpose.

You will need to contact your investment company to:
• Get the correct Routing Number for this special account. Ask if this account is held in another
institution. If so, you will see this other name when we confinn your direct deposit infonnation.
• VerifY the Account Number to use. (It may be different than the number shown on your

investment account statement.)

Routing Number (9 digits)
Please enter your 9 digit routing number.

Account Number
Please enter your account number.

[EXit]
LN p~i()r P~ge:

J [.Contil1ue J

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When Will This Start?

Page 1 of 1

Skip to C~!1tral-Content
--Social Security Online
Start Direct Deposit
'>Y'!I\V~social§~curity.gov
-- - _ . -- - .. I

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Social Security logo !

When Will This Start?
Let us know how soon you want your direct deposit to start.

Important
• Be sure that the first payment has been direct deposited in your account before you begin
withdrawing funds from the account.
• Your normal payment date will remain the same.

When do you want this to take effect?

- 0 When do you want this to take effect? As Soon As Possible (Note: it may not take effect before your
next payment.) As Soon As Possible (Note: it may not take effect before your next payment.)
- 0 Wait until my payment in November 2008 Wait until my payment in November 2008
Wait until my payment in December 2008 Wait until my payment in December 2008
[ Exit
pripr Page ) [ C()ntinu~J

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Verity Your Information

Page 1 ofl

Skip to Cen.tral CQl'lt~nt
Social Security Online
Start Direct Deposit
www.socialsc(;urity.gov

.0

1

Social Security logo

i

Verify Your Information
You requested we start your direct deposit to this account:
Bank name:
Routing number:
Account number:
Account type:
To take effect:

USAA FEDERAL SAVINGS BANK
314074269
0987654321
Savings Account
September 2005

If this information is correct, tell us to complete your request by selecting "Confirm."
[ Con~rmJ

If this information is NOT correct, you can change it now.

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Confinuation

Page 1 of1

Skip to Central Conl(!nt
Social Security Online
Start Direct Deposit
';'YW'!! .sQJ::ialsecllrity"gov
I

[!]

Social Security logo .

!

Confirmation
Thank you RODNEY KEZER!

You have successfully submitted your direct deposit information.

Our records may take 3-5 days to reflect this change.
This is your online confinuation. You will also get a confinuation letter from Social Security shortly
before the first payment goes to your new account.
.
For security reasons, if anyone else in your household needs to start or change direct deposit, you
will have to log out and this person will have to do this for him or herself.
You requested to start direct deposit to:
Bank name:
Routing number:
Account number:
Account type:
To take effect:

USAA FEDERAL SAVINGS BANK
314074269
0987654321
Savings Account
September 2005

We suggest you print this page for your records.
Continue: ]

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Direct Deposit Survey 1

Page I of2

Skip to Central Content
Social Security Online
Start or Change Direct Deposit
www.socialsecurity~~ov

,'r~
l!J

Social Security logo

,i

Direct Deposit Survey
We'd like to know what you think of our online "Start or Change Direct Deposit" service. Please take a
minute to read our survey below and answer all the questions that apply. Ifyou prefer, you can skip this
survey and continue on to other tasks.

(

S.. k. . . . .i.. p. Survey
y
"________ . and Continue

C'''''''',

__ ,

.f

•

)

Was it easy to find the "Start or Change Direct Deposit" service?
Was it easy to imd the "Start or Change Your Direct Deposit" service?Yes
imd the "Start or Change Your Direct Deposit" service?No

Was it easy to

Was it easy to understand what information you needed to provide?
Was it easy to understand what information you needed to provide?Yes
understand what information you needed to provide?No

o Was it easy to

Were the instructions easy to understand?
Were the instructions easy to understand?Yes

Were the instructions easy to understand?

No

Did we tell you everything you needed to know about your direct deposit request?
Did we tell you everything you needed to know about your direct deposit request?Yes
we tell you everything you needed to know about your direct deposit request?No

Did

Overall, did you think it was easy to complete your request for direct deposit?
Overall did you think it was easy to complete your request for Direct Deposit?Yes 0 Overall
did you think it was easy to complete your request for Direct Deposit?No

Would you do business with us online again based on your experience today?
Would you do business with us online again based on your experience today?Yes OWould
you do business with us online again based on your experience today?No

Feedback

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11712010

Direct Deposit Survey 1

Page 2 of2

If you answered "no" to any ofthese questions and need to tell us more, please enter your feedback and
share your thoughts.
Thank you for responding!
(

Submi~

j

See Revised Privacy Act
Statement
The Privacy Act requires us to notifY you that we are authorized to collect this infonnation by section
702 ofthe Social Security Act. You do not have to provide the infonnation requested. However, the data
you provide will allow the Social Security Administration to improve our web site design and better
serve you in the future. This survey is completely anonymous.

Privacy Act

Paperwork Reduction Act See Revised Paperwork
Reduction Act

This infonnation collection meets the clearance requirements of 44 U.S.C. § 3507, as amended by
section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we
display a valid Office of Management and Budget (OMB) control number. We estimate that it will take
about 3 minutes to read the instructions, gather the facts, and answer the questions. You may send
comments on our time estimate above to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401. Send
only comments relating to our time estimate to this address, not the completed form.
The OMB control number for this Direct Deposit application is 0960-0634; expiration date
XXlXXlXXXX.

Additional Information
If you need additional information, we can help you.
• You can call us at 1-800-772-1213, Monday through Friday between 7 a.m. and 5 p.m. EST.
• You can visit your local Social Security Office. You can get directions and a map to your local
Social Security Office by visiting the EiQld OtIice Loc'!tor.
• If you are outside of the United States, contact your nearest Social Security office, U.S. Embassy
or consulate, or the Veterans Affairs Regional Office (VARO) in the Philippines.
[ Subr,nit

1

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Direct Deposit Survey 2

Page 1 of2

Skip to Central COl}t~nt
Social Security Online
Start or Change Direct Deposit
~~ww.socialsecurity.gov

i

0

SocialSecurity logo:

Direct Deposit Survey
We're sorry you decided not to complete your online request using our "Start or Change Direct Deposit"
service today. We'd like to understand why so we can improve this service in the future. Please take a
minute to read our survey below and answer all the questions that apply. If you prefer, you can skip this
survey and continue on to other tasks.
[ PriQrPage)

Did you decide not to finish your request today because:
You didn't have the information you needed to complete your request?

-o You didn't have the information you needed to complete your request?Yes o You didn't have
the information you needed to complete your request?No

The questions were hard to fill out?
- 0 The questions were hard to fill out?Yes

The questions were hard to fill out?No

The instructions or questions were not clear?
The instructions or questions were not clear?Yes
clear?No

The instructions or questions were not

It was taking too long to complete the request?

- 0 It was taking too long to complete the request?Yes

It was taking too long to complete the

request?No

Do you still plan to start or change direct deposit of your benefits?
- () Do you still plan to change or start direct deposit of your benefits?No
o Yes, using the online service
Do you still plan to change or start direct deposit of your benefits?Yes, but not online

Feedback
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Direct Deposit Survey 2

Page 2 of2

If you answered "no" to any of these questions and need to tell us more, please enter your feedback and
share your thoughts.
Thank you for responding!
[

~ubmit

I

Privacy Act
The Privacy Act requires us to notifY you that we are authorized to collect this infonnation by section
702 of the Social Security Act. You do not have to provide the infonnation requested. However, the data
you provide will allow the Social Security Administration to improve our web site design and better
serve you in the future. This survey is completely anonymous.

Paperwork Reduction Act

See Revised Reduction Act

This infonnation collection meets the clearance requirements of 44 U.S.C. § 3507, as amended by
section 2 of the Paperwork Rt!4uction Act of 1995. You do not need to answer these questions unless we
display a valid Office of Management and Budget (OMB) control number. We estimate that it will take
about 3 minutes to read the instructions, gather the facts, and answer the questions. You may send
comments on our time estimate above to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401. Send
only comments relating to our time estimate to this address, not the completed form.
The OMB control number for this Direct Deposit application is 0960-0634; expiration date
XXlXXIXXXX.

Additional Information

If you need additional infonnation, we can help you.

• You can call us at 1-800-772-1213, Monday through Friday between 7 a.m. and 5 p.m. EST.
• You can visit your local Social Security Office. You can get directions and a map to your local
Social Security Office by visiting the fielFile Typeapplication/pdfFile Modified2010-01-29File Created2010-01-08