Illinois Direct Deposit Form 3 - Free Download | Page 2
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Illinois Direct Deposit Form 3
Required Account Information
Important: The name of the person who will receive the IMRF benet payments
must be on this account.
IMRF needs you to provide specic account information on the reverse side of this form
in order to set up Direct Deposit:
Name of your nancial institution
Phone number of the branch you use
Address of the branch you use
Your account number
Your nancial institution’s routing number
Type of account
A routing number is a nine-digit number, and is a completely separate number from your
account number.
If you have a savings or brokerage account, you should call the nancial institution
where you have your account to obtain the correct routing number.
If you have a checking account, see the sample below for how to get your account
number and the correct routing number from your blank checks. (Note: If you have
temporary checks, call the nancial institution where you have your account to obtain
the correct routing number.)
Member Service Representatives 1-800-ASK-IMRF (1-800-275-4673)
www.imrf.org
IMRF Form 1199 (Rev. 07/07)
Mary Member 9676
John Member
123 Main Street Date _______________________
Anywhere, IL 60606
Pay to the
Order of _____________________________________________________________
_______________________________________________________________________________Dollars
Bank of Anywhere
Anywhere, IL 00000
For______________________________________ ___________________________________
I:123456789I: 1122334455 II 9676
$
Nine-digit
Routing Number
Account
Number
Do not include
the check number
as part of your account
number. (The check
number is generally
printed immediately
after your account
number.)
SAMPLE
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