Social Security Direct Deposit Authorization Form 1199A

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The Social Security direct deposit form is a document used to initiate immediate electronic payments to beneficiaries of Social Security. This is a standard form used for all workers of all government agencies wishing to receive payments directly into a checking or savings account. The information submitted by the payee (in sections 1 and 2) must be 100% accurate before sending it to the financial institution where they are an account holder. The institution will then complete section three (3) and return the completed form to the Government Agency indicated therein.

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  • Telephone – 1(800) 333-1795

How to Write

Step 1 – Begin by downloading the form in Adobe PDF.


Step 2 – The first section of the form asks that you supply the following personal information:

  • Name of payee
  • Address
  • Telephone number
  • Name of person(s) entitled to payment
  • Claim or Payroll ID Number
  • Type of depositor account
  • Checking or savings
  • Depositor account number
  • Type of payment
  • Type of payment allotment
  • Amount of payment

Step 3 – The “Payee/Joint Payee Certification” box asks for the signature and date from each payee. The same must be provided by the joint account holders. This, of course, can only be accomplished once the form has been completed and printed.

Step 4 – “Section 2” should be filled in by the payee or the financial institution. The first field is for the government agency name, the second is for their address.

Step 5 – Once all the fields have been double checked for accuracy, print off the form and have each payee/account holder sign it. Send it to the financial institution where your account is held to have them fill out the third section.