STATE OF ALABAMA 
DIRECT DEPOSIT REQUEST 
(This is a fillable form. Just use tab to move from field to field and enter the required information.  
Use file; “save as” to save a copy to your computer.) 

he  State  of  Alabama  is  requested  to  electronically  transfer  my  salary  to  the  financial 

ccount Type: 

(Check 1 box only) Checking 

 (or) Savings 

  

institution listed below. 

ame of Financial Institution: 

           

ccount Number: 

ank Routing Number: 

           

           

Type/Print Employee’s Name 

Employee’s Social Security Number 

Employee’s HOME Mailing Address (Street) 

City, State, and Zip Code of Employee’s Home Mailing Address  

Employee’s Department or Agency 

Employee’s Home Telephone Number 

           
Work Telephone Number 

___________________________                                       

Date 

Signature of Employee 
 

It is strongly recommended that the employee have his financial 
institution verify the information on the completed form. 

FRMS-15 
Rev. 05/08 
 

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Direct Deposit Request

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About This Form:

• Sourced from eforms.alacourt.gov (2023-03)
• Page(s): 1
• Fields(s): 17
• Average fields per page: 17
• Reading Level: Grade 10
• LIST Grouping(s): Unknown

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