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    Direct Deposit Form: B e N o I T J A M e S K

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    Kevin Benoit
    Kevin Benoit is completing a direct deposit form to set up direct deposit of his benefits from Unum into his Walmart MoneyCard checking account. He provides his personal information and banking details, including his routing and account numbers. The form explains that direct deposit allows payments to be electronically deposited into his account on a weekly or monthly basis according to his policy. It also provides contact information for questions about the direct deposit process.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Direct Deposit Form: B e N o I T J A M e S K

    Uploaded by

    Kevin Benoit
    106 views1 page
    Kevin Benoit is completing a direct deposit form to set up direct deposit of his benefits from Unum into his Walmart MoneyCard checking account. He provides his personal information and banking details, including his routing and account numbers. The form explains that direct deposit allows payments to be electronically deposited into his account on a weekly or monthly basis according to his policy. It also provides contact information for questions about the direct deposit process.

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    Kevin Benoit is completing a direct deposit form to set up direct deposit of his benefits from Unum into his Walmart MoneyCard checking account. He provides his personal information and banking details, including his routing and account numbers. The form explains that direct deposit allows payments to be electronically deposited into his account on a weekly or monthly basis according to his policy. It also provides contact information for questions about the direct deposit process.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    106 views1 page

    Direct Deposit Form: B e N o I T J A M e S K

    Uploaded by

    Kevin Benoit
    Kevin Benoit is completing a direct deposit form to set up direct deposit of his benefits from Unum into his Walmart MoneyCard checking account. He provides his personal information and banking details, including his routing and account numbers. The form explains that direct deposit allows payments to be electronically deposited into his account on a weekly or monthly basis according to his policy. It also provides contact information for questions about the direct deposit process.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    DIRECT DEPOSIT FORM

    The Benefits Center


    P.O. Box 100158, Columbia, SC 29202-3158
    Toll-free: 1-800-413-7671  Fax: 1-866-747-5940
    Please provide the information requested below. Once completed, sign and date the form, attach the appropriate documentation
    and mail or fax it to the address or fax number indicated above. As a convenience, we also offer a secure website at www.unum.
    com/claimant where you can sign up for direct deposit.
    A. Information About You
    Last Name First Name MI
    b e n o i t j a m e s K
    Address
    1 2 3 4 0 h w y 3 5
    City State Zip
    b e n t o n a r 7 2 0 1 5 -
    Social Security Number Home Telephone Number
    4 6 7 8 4 6 1 9 9 5 0 1 2 4 9 0 2 2 7

    B. Information About How to Set-up or Change Your Direct Deposit

    ✔
    o  Set-up Direct Deposit o  Change Direct Deposit Account
    Bank/Financial Institution Information
    Name

    w a l m a r t m o n e y c a r d
    City State Zip

    p a s a d e n a c a 9 1 1 1 7 - 0 1 0 0

    Choose Type of Account – Note: We are only able to deposit benefit payments into one account.
    ✔
    o Checking  OR  o Savings

    REQUIRED FOR CHECKING: Please provide either 1.) a voided check imprinted with your name; or
    2.) the top portion of a bank statement or a letter from your bank, on bank letterhead, signed and
    dated by a bank representative. One of these items must be received to process your request.
    Please note: additional documentation is not required for direct deposit into a savings account.
    Please verify the Transit Routing number with your bank.
    A Routing Number beginning with the number 5 is not valid. (Ex: 502000027)
    Bank Transit/Routing Number Personal Account Number
    1 2 4 3 0 3 1 2 0 9 1 8 1 9 1 0 0 0 5 5 5 2 6 3 9 4

    C. Direct Deposit Cancellation Request


    Please complete this section if you are canceling your direct deposit agreement.
    o Cancel my direct deposit agreement  Effective Date

    D. Signature of Individual

    X Kevin benoit 02/09/2021


    _____________________________________________________________________________ _______________________________________
    Signature of Individual Date

    Frequently Asked Questions About Direct Deposit


    • What is Direct Deposit?
    Unum will deposit your benefits directly into your checking or savings account on a weekly or monthly basis as per policy provisions.
    • When can I expect the money to be in my account?
    Because this can vary from person to person, please discuss the details with a Direct Deposit Specialist. Funds will be credited on the second business day
    after the date of release of funds with the exception of a Federal Reserve Bank Holiday.
    • What if I have questions?
    Please call our toll-free Direct Deposit Customer Service line at 1-800-413-7671. Knowledgeable and courteous representatives are available to answer your
    questions, Monday through Friday, 8 a.m. to 4 p.m. Eastern Standard Time.
    Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

    CS-1164 (11/15)

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