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City of Roseville Police & Fire Retirement System
Will the pension payment that is made via direct deposit pursuant to this Authorization be forwarded across the U.S. Border to a foreign financial institution thought the ACH network on the same day that it is deposited into your account?
City of Roseville #089686
If Pension is being deposited into only one account, please leave this field blank.
Complete ONLY if you wish to have your Pension deposited into two different accounts each month
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I certify that the information I have provided on this Electronic Transfer Authorization Form is correct and complete. I understand that this Authorization will remain in effect until I submit written authorization to cancel or change the information contained herein. I authorize and direct Comerica Bank to make the monthly pension payment payable to me under the CITY OF ROSEVILLE POLICE & FIRE RETIREMENT SYSTEM plan via the Automated Clearing House (ACH) system to the financial institution(s) and account number(s) named herein.
This field is not part of the form submission.
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