DSHS Form 18-484 Automatic Payment Authorization and Electronic Funds Transfer Information - Washington

What Is DSHS Form 18-484?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 18-484?
A: DSHS Form 18-484 is the Automatic Payment Authorization and Electronic Funds Transfer Information form.

Q: What does the form authorize?
A: The form authorizes the Department of Social and Health Services (DSHS) to make automatic payments and electronic funds transfers.

Q: Who needs to fill out this form?
A: Individuals who receive benefits from DSHS and want to set up automatic payments or electronic funds transfers need to fill out this form.

Q: What information is required on the form?
A: The form requires personal information, bank account information, and signature of the applicant.

Q: Is there a fee to set up automatic payments?
A: No, there is no fee to set up automatic payments through this form.

Q: Can I cancel or change my automatic payments?
A: Yes, you can cancel or change your automatic payments by contacting DSHS or your bank.

Q: Are electronic funds transfers secure?
A: Yes, electronic funds transfers are secure and protected by federal laws.

Q: Can I use this form for other purposes?
A: No, this form is specifically for setting up automatic payments and electronic funds transfers with DSHS.