Direct Deposit Form

REQUEST FOR DIRECT DEPOSIT
OF MONTHLY PENSION CHECK

To: Watertown Retirement Board
P.O. Box 199, 149 Main Street
Watertown, MA 02471-0199
(617) 972-6456

From:
(Retiree Name)

(Address)

(City/State/Zip)

(Telephone number - 10 digit)

Effective please make arrangements to have my
(Date)
monthly retirement check deposited directly into my account held at the following:
Bank Name:

Checking Account - Please provide a Voided Personal Check
Savings Account - Please provide a Savings Account Deposit Slip
(Enter asterisk or check appropriate box)

Signed: _______________________________________________

Date: ____________________

Please Note: One pay period is required to set up the Direct Deposit Account. Therefore, the first retirement check issued after the date you wish to establish the account will be a LIVE CHECK payable to you. The following month the account will be established and your check will be directly deposited into your bank account.
If you have any questions, please contact our office.

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REQUEST FOR DIRECT DEPOSIT OF MONTHLY PENSION CHECK
To:	Watertown Retirement Board P.O. Box 199, 149 Main Street Watertown, MA 02471-0199 (617) 972-6456
From:	(Retiree Name)
	(Address)
	(City/State/Zip)
	(Telephone number - 10 digit)
Effective please make arrangements to have my (Date) monthly retirement check deposited directly into my account held at the following: Bank Name:
Checking Account - Please provide a Voided Personal Check Savings Account - Please provide a Savings Account Deposit Slip (Enter asterisk or check appropriate box)
Signed:	_______________________________________________
Date:	____________________
Please Note: One pay period is required to set up the Direct Deposit Account. Therefore, the first retirement check issued after the date you wish to establish the account will be a LIVE CHECK payable to you. The following month the account will be established and your check will be directly deposited into your bank account. If you have any questions, please contact our office.