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Direct Deposit Instruction Page
Prepared my Mike Gedert, DPMU, Training Officer, Region 5 and
Kirsten Clatterbuck, National Disaster Medical Systems (NDMS)

Direct Deposit Signup Form
(now in adobe fillable PDF format)
Letter from NDMS regarding form

Please send completed form to:
Kirsten Clatterbuck
National Disaster Medical Systems (NDMS)
12300 Twinbrook Parkway, Suite 360
Rockville, MD 20852

The only copy of this that you will need to worry about is the GOVERNMENT AGENCY COPY. But when you are done, make a copy of your completed form for your own records, and keep a blank copy in case you ever need to change your bank account in the future.

Boxes A and B : Fill in with YOUR name, address and phone number Box C : Disregard the "prefix" and "suffix" and just enter your Social Security number Box D : Check either checking or savings (I would suggest CHECKING so you can attach a check with the tracking number and bank name on it.) Box E : Enter the account number for that account Box F : CHECK "OTHER" AND WRITE "TRAVEL" ON THE LINE
Box G : It is thought that this is if you have a percentage of your earnings that MUST be sent to someone else. (ie. Alimony, etc) If this is the case, you might want to e-mail Kirsten for clarification. PAYEE/JOINT PAYEE CERTIFICATION: Sign and date (THIS AREA MUST BE
SIGNED)
JOINT ACCOUNT HOLDERS' CERTIFICATION: Have joint account holder sign and date.
SECTION 2 : Government agency would be FEMA. Don't enter an address, they will do that for you. SECTION 3 : Just attach a voided check and you don't have to do anything with this. And you DON'T have to take this to your financial institution.

A SUGGESTION THAT I WOULD LIKE TO MAKE IS AFTER YOU HAVE COMPLETED THIS FORM, MAKE A COPY OF THE FORM AND PLACE IT AND A VOIDED CHECK IN YOUR DEPLOYMENT BAG OR WITH YOUR UNIFORMS SO YOU HAVE IT WHEN DEPLOYED. MANY TIMES YOU WILL NEED TO COMPLETE ONE OF THESE FORMS AGAIN WHEN YOU ARE DEPLOYED. HAVING THIS ONE WITH YOU WILL: a) MAKE IT MUCH EASIER TO FILL THAT ONE OUT, AND b) MAKE SURE YOU PUT THE EXACT SAME INFORMATION ON THE NEW ONE SO THERE ISN'T ANYTHING THAT WOULD DIFFER FROM THE ONE ON RECORD AND POSSIBLY SLOW DOWN YOUR PAY.