
DD-1
Electronic
(rev. 09/2012)
OPR: Benefits
Mail to: Alabama Department of Labor
Attn Fund Control Room 5228
649 Monroe Street
Montgomery, Al 36131
ALABAMA DEPARTMENT OF LABOR
AGREEMENT FOR DIRECT DEPOSIT
Please Print
Name Social Security Number:
□
□
START
STOP
I authorize the Alabama Department of Labor to make automatic deposit of the
full amount of any payments of my weekly unemployment benefits to my:
□ Checking Account □ Savings Account
(ATTACH VOIDED CHECKS (ATTACH DEPOSIT SLIP)
I authorize the Alabama Department of Labor to terminate the automatic deposit of
payments of unemployment benefits.
I authorize the Alabama Department of Labor to change the automatic deposit of
payments of unemployment benefits according to the changes shown below. I
understand that the Alabama Department of Labor can automatically deposit unemployment benefits only
to a separate or joint banking account under which the name of the above claimant is listed and that the
Department will not become involved in any disputes regarding the use of funds deposited into joint
accounts.
NAME OF BANK OR FINANCIAL INSTITUTION
□ Checking □ Savings
NUMBER
This authorization shall remain in effect, regardless of the establishment of any subsequent benefit year claim and until the Alabama
Department of Labor has received written notification from me to terminate or otherwise change the automatic deposit of my
unemployment benefits. Such notification shall be delivered in a timely manner in order to afford the Alabama Department of Labor
an opportunity to comply. In no event shall any such termination or change affect any unemployment benefits previously processed
by the Alabama Department of Labor for automatic deposit at the time of the notification.
In the event of an error in the automatic deposit of my unemployment benefits to my account, I authorize my named banking
institution to correct the error in my account. I also understand that all transactions with my account by the Alabama Department of
Labor shall be governed by the Rules of the Automated Clearing House Association.
I also understand that the Alabama Department of Labor is NOT responsible for errors in the bank transit routing numbers or in the
account number as listed above, and is further NOT responsible in the event that the above selected institution is not participating in
the Direct Deposit program through the Federal System.
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DATE______________