EFT Enrollment Request Form

State of Oklahoma Vendor Registration

Office of Management and Enterprise Services
Office of the State Treasurer

As a recipient of funds issued from a State of Oklahoma government agency, your information is maintained in the
State of Oklahoma PeopleSoft Vendor Payment System. All payments issued by Oklahoma state agencies are subject
to state law (Title 62, Section 34.64) requiring that: "Payments disbursed from the State Treasury shall be conveyed
solely through an electronic payment mechanism." To comply with the law, the Treasury must collect the information
necessary to pay all individuals and companies electronically.

In order for the Office of Management and Enterprise Services (OMES) and the Office of the State Treasurer (OST) to
approve future payments, your assistance is required to complete the attached Electronic Funds Transfer Enrollment
Request Form.

Form Instructions:

The Electronic Funds Transfer Enrollment Request Form consists of three sections that are required to be completed
in order for such request to be processed. Please ensure the following information is completed correctly prior to
submitting for approval:

Section I – Payee Information

(i) Include accurate Tax Identification number (TIN) and Payee Name as filed with the U.S. Internal Revenue Service.
A TIN is the Social Security number (SSN) for an individual or Employer Identification number (EIN) for a business.
(ii) Include the correct remittance address(es) applicable for EFT bank information provided. To ensure faster
payment processing, please provide all applicable remittance addresses.
Section II – EFT Enrollment Request Type
(i) Select the applicable request type for adding EFT information or changing the EFT information currently
maintained in your state payee records.
(ii) To prevent fraudulent bank changes to your payee record, change requests require verification of the bank
account and routing numbers being changed. For additional security, a change notification letter is also
mailed to the primary business address currently on file.
Section III – Payee EFT Enrollment Request and Authorization
(i) Include signature by an authorized individual, with the requisite authority to open and close bank accounts for
the payee.
(ii) Businesses should include both requestor and authorized individual signatures.
a. The requestor is an individual who has authority to initiate the EFT payment authorization process on
behalf of the company.
b. The authorized individual must be someone different from the requestor, such as a business official or
manager with company verification authority.
c. Sole proprietors and individuals should provide only the authorized individual signature. Please include
a W-9 for verification purposes.
Section IV – Financial Institution Information
(i) Must be completed and signed by an authorized official of the payee’s financial institution.
(ii) Fax completed form to the attention of PeopleSoft Vendor Registration, Office of the State Treasurer, at 405-
521-4994, or mail it to the attention of PeopleSoft Vendor Registration at Office of the State Treasurer,
2300 N. Lincoln Blvd., Room 217, Oklahoma City, OK 73105.
(iii) To ensure the protection of your banking data, please do not email bank forms.
(iv) Please retain a copy for your records.

For assistance, please contact the OMES Service Desk by emailing servicedesk@omes.ok.gov or calling 405-521-
2444 or toll-free 866-521-2444.

EFT Enrollment Request Form 1