This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Electronic Benefit Payment Deduction Authorization Form is a legal document that was released by the Montana Department of Administration - a government authority operating within Montana.
Q: What is the Electronic Benefit Payment Deduction Authorization Form?
A: The Electronic Benefit Payment Deduction Authorization Form is a document used in Montana to authorize the deduction of benefit payments from an individual's bank account.
Q: What is the purpose of this form?
A: The purpose of this form is to allow the Montana Department of Public Health and Human Services to deduct benefit payments directly from a recipient's bank account.
Q: Who needs to fill out this form?
A: This form needs to be filled out by individuals who receive benefits from programs administered by the Montana Department of Public Health and Human Services and wish to authorize the deduction of payments from their bank account.
Q: What benefits can be deducted using this form?
A: This form can be used to authorize the deduction of various benefits, such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Medicaid payments.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Montana Department of Administration.