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Direct Deposit Authorization  

Please select the type of Authorization you wish to perform:

Create New Direct Deposit Authorization
Edit Existing Direct Deposit Authorization

Direct Deposit Request On Behalf Of:

Individual Account
Instructions & Important Information

If you are a Broker who is paid commissions directly under your own Social Security number, Information about you will be pre-filled on this form.

If you are completing a Direct Deposit Authorization as a delegate of your agency, Information for your agency will be pre-filled on this form.

You will need to use this same form if you wish to change to or cancel your Direct Deposit Authorization in the future.

Required Information:

You will be required to agree to an electronic signature and to accept the terms of submission for this Direct Deposit Authorization.

You may elect to authorize deposit for up to two accounts. To complete the Direct Deposit Authorization, you will need to provide the following information about the account(s) This information is normally pre-printed on your check or deposit slip:

  • The financial institution name(s) where you wish have funds deposited.
  • The financial institution City, State, and Zip
  • The routing / ABA number and account number for your account(s) (an example is shown below)
  • The type of account(s) for which you are authorizing deposit (checking / savings)
  • Whether you prefer to split the deposit into two separate percentage amounts, or deposit the full amount into one account.

Finalizing the Direct Deposit Authorization:

Please note, the Direct Deposit Authorization will not be complete until you receive a confirmation message. You should print and save copy of this authorization for your records, you will be given the chance to do so at the end of this process. A copy of the terms of submission and electronic signature will be included in this printout. A copy of the Direct Deposit Authorization with your electronic signature will also be kept on file at UnitedHealthcare.

Direct Deposit Availability:

Direct Deposit Authorization will take approximately 4 weeks to take effect.

Please note that commission funds are always deposited to your account(s) 3 business days after the commission statement date.

Making Changes to or Canceling your Direct Deposit Authorization:

To change any of the information contained in your existing Direct Deposit Authorization, please select "Edit Existing Direct Deposit Authorization" option above and enter all required information on the Direct Deposit Authorization form. The new authorization will replace the existing Direct Deposit Authorization on file with UnitedHealthcare.

If you wish to stop your direct deposit, please select "Cancel Direct Deposit Authorization" above and enter all required information on the Direct Deposit Authorization form.

Changes to your existing direct deposit will be effective within 4 weeks.

Questions and Support:

For general questions about Direct Deposit or assistance with this completing this form, please call UnitedHealthcare Broker Commissions Customer Service at 1-888-641-9147.

Sample Routing & Account Number Location:
View Routing/ABA & Account Number Example