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Glenn Hegar  ·  Texas Comptroller of Public Accounts

Payment Services Forms (Numerical)

Name Number Description
Used by agencies to request the daily debtor hold extract file.
Used by a hold source agency to authorize the release of a held warrant.
Used by agencies to request cancellations of forged warrants that are reinstated or for post-dated payroll deduction warrants.
Used by a hold source agency to set up, change or release hold information for a state debtor.
Used by agencies requesting updates to payee information in the Texas Identification Number System (TINS); may be provided by the agencies to their payees.
Used by agencies to provide to payees who wish to receive state payments by direct deposit or change/cancel existing direct deposit information.
Used by agencies requesting to report state debts or change existing hold agency information.
Used by agencies to authorize personnel to pick up warrants.
Used as an agreement between a state agency and the Comptroller’s office that allows the agency to receive post-dated payroll warrants before payday
Used by agencies to request an erroneous direct deposit payment be reversed through the Automated Clearing House (ACH) system.
Used by agencies to apply for a special payee identification number for low dollar, one-time payments to multiple payees.
Used by the Comptroller’s Revenue Accounting Division to provide to taxpayers who wish to receive tax refund payments by direct deposit.
This form is used by employees to sign up to receive payroll payments through the Employee PayCard program.
Used by a agencies upon notification of a payee’s death to reclaim a pension, annuity or benefit payment made by direct deposit for which the payee or its estate was not entitled.
Used by agencies who must require payees to confirm whether their state payments are destined to be forwarded outside of the U.S.
Used by agencies to request an ACH trace number for a state direct deposit payment.
Used by agencies to obtain necessary information from payees to set up a Texas Identification Number (TIN).
Glenn Hegar
Texas Comptroller of Public Accounts
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